Provider Demographics
NPI:1871540336
Name:KINSEY, CHARLES M (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:M
Last Name:KINSEY
Suffix:
Gender:M
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:FAHC PULMONARY AND CRITICAL CARE
Mailing Address - Street 2:111 COLCHESTER AVENUE
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05405-0001
Mailing Address - Country:US
Mailing Address - Phone:802-847-1158
Mailing Address - Fax:
Practice Address - Street 1:FAHC PULMONARY AND CRITICAL CARE UNIT
Practice Address - Street 2:89 BEAUMONT AVENUE- GIVEN D208
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05405-0001
Practice Address - Country:US
Practice Address - Phone:802-656-3525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228030207R00000X, 207RP1001X
VT042.0012659207RC0200X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine