Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 042.0014276 | VT |
N | 111NI0900X | Internist | 042.0014276 | VT |
Y | 207RG0100X | Gastroenterologist | 042.0014276 | VT |
NPI | 1003876368 |
---|---|
Provider Name | Dr. Alan Landau |
First Address | Colchester, VT 05446-4460 |
Second Address | Colchester, VT 05446 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 16/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E41435 | (02) | CT |