Provider Demographics
NPI:1952369654
Name:PAIS, VERNON M JR (MD)
Entity Type:Individual
Prefix:
First Name:VERNON
Middle Name:M
Last Name:PAIS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC - SECTION OF UROLOGY
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-6053
Mailing Address - Fax:603-650-4985
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC - SECTION OF UROLOGY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-6053
Practice Address - Fax:603-650-4985
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY39642208800000X
NH13920208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1003860Medicaid
NH30204253Medicaid
KY64102932Medicaid
KY0929158Medicare PIN
NH000598701Medicare PIN
NH30204253Medicaid