Individual
PAUL D. BOUTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
51 FAIRVIEW STREET, BRATTLEBORO, VT 05301-6629
(802) 254-6028
(802) 254-7501
Mailing address
390 RIVER STREET, SPRINGFIELD, VT 05156-2226
(802) 886-4500
(802) 886-4520
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
042 0011364
VT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
042.0011364
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013948
—
VT
05
—
3113771
—
NH
Enumeration date
08/16/2006
Last updated
11/27/2019
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