Provider Demographics
NPI:1215905435
Name:HUBER, DEBORAH S (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:S
Last Name:HUBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 CATAMOUNT PARK
Mailing Address - Street 2:EXCHANGE STREET
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-1292
Mailing Address - Country:US
Mailing Address - Phone:802-388-6777
Mailing Address - Fax:802-388-3445
Practice Address - Street 1:82 CATAMOUNT PARK
Practice Address - Street 2:EXCHANGE STREET
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1292
Practice Address - Country:US
Practice Address - Phone:802-388-6777
Practice Address - Fax:802-388-3445
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039999207Q00000X
VT042-0012447207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT01399999Medicaid
CT080001518Medicare ID - Type Unspecified
CT01399999Medicaid