Paul Gregory Boerman
Oral and Maxillofacial Surgeon
44 Timber Lane
South Burlington
, Vermont 05403-7282
Paul Gregory Boerman
Oral and Maxillofacial Surgeon
44 Timber Lane
South Burlington
, Vermont 05403-7282
(802) 864-1511
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Paul Gregory Boerman
- 44 Timber Lane
- South Burlington, VT
- Zip : 05403-7282
- Fax : (802) 864-1511
- Phone : (802) 860-6725
Second Address
- Paul Gregory Boerman
- 44 Timber Lane
- South Burlington, VT
- Zip : 05403-7282
- Fax : (802) 864-1511
- Phone : (802) 860-6725
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 0160000990 | VT |
National Provider Identifier
| NPI | 1104830512 |
|---|---|
| Provider Name | Paul Gregory Boerman |
| First Address | South Burlington, VT 05403-7282 |
| Second Address | South Burlington, VT 05403-7282 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/07/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 102V101 | MVP (01) | VT |
| 8309 | BCBS (01) | VT |
| 9446 | (05) | VT |
| U10327 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.