# CHAMPLAIN VALLEY INTERNAL MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407999345
- **Authorized official:** MARK SILVERSTEIN M.D. (PHYSICIAN)
- **Authorized official phone:** (802) 524-5617

## Contact information

- **Practice address:** 77 FAIRFIELD ST, SAINT ALBANS, VT 05478-1716
- **Practice address phone:** (802) 524-5617
- **Practice address fax:** (802) 527-7149
- **Mailing address:** PO BOX 1327, WILLISTON, VT 05495-1327
- **Mailing address phone:** (802) 524-7100
- **Mailing address fax:** (802) 524-7021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/14/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0VN1746 | — | VT |
| 05 | — | 1013582 | — | VT |