Provider Demographics
NPI:1396766150
Name:COVE, WILLIAM J (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:COVE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:ATT: CVMC FINANCE DEPT
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-0547
Mailing Address - Country:US
Mailing Address - Phone:802-244-7874
Mailing Address - Fax:802-244-4106
Practice Address - Street 1:130 S MAIN ST
Practice Address - Street 2:WATERBURY MEDICAL ASSOCIATES
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05676-1519
Practice Address - Country:US
Practice Address - Phone:802-224-7874
Practice Address - Fax:802-244-4106
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT032-0000310207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3091432Medicaid
VT0009799Medicaid
VTOX1082Medicare PIN
NH3091432Medicaid
VT9799Medicare ID - Type Unspecified