Roger E Ehret, MD

Individual provider Active NPI Obstetrics & Gynecology Physician · Berlin, VT

NPI 1528089307 · NPPES record last updated Dec 4, 2014

Key facts

NPI
1528089307
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
042-0009344 (VT)
Practice address
130 Fisher Rd
Mob-a Suite 1-4
Berlin, VT 05602-9516
Phone
(802) 371-5961
Fax
(802) 371-5960
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0009344VTMDObstetrics & Gynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 042-0009344 VT Yes

Addresses

Primary practice location

130 Fisher Rd
Mob-a Suite 1-4
Berlin, VT 05602-9516

Mailing address

PO Box 547
Central Vermont Medical Center - Finance Dept
Barre, VT 05641-0547
Phone (802) 371-5961

Other identifiers

IdentifierTypeStateIssuer
OVN1415MedicaidVT

Other providers in Berlin, VT

All providers in Berlin, VT · Obstetrics & Gynecology Physician in Vermont

Sources for this page

Verify at the official NPI Registry.