Individual
STEPHEN M KOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 PORTER DR, RADIOLOGY DEPARTMENT, MIDDLEBURY, VT 05753-8423
(802) 388-8851
Mailing address
1119 BASIN HARBOR RD, BRIDPORT, VT 05734-9570
(802) 388-8851
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
042-0009220
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN1562
—
VT
Enumeration date
06/29/2006
Last updated
07/08/2007
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