# NORTHWESTERN MEDICAL CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northwestern Urology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205249893
- **Authorized official:** MARY PIGEON (CRED. SPECIALIST)
- **Authorized official phone:** (802) 524-8954

## Contact information

- **Practice address:** 1 CREST RD, SUITE C, SAINT ALBANS, VT 05478-9753
- **Practice address phone:** (802) 524-0719
- **Practice address fax:** (802) 524-8421
- **Mailing address:** 1 CREST RD, SUITE C, SAINT ALBANS, VT 05478-9753
- **Mailing address phone:** (802) 524-0719
- **Mailing address fax:** (802) 524-8421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 818 | VT | Yes |

## Other

- **Enumeration date:** 06/11/2014
- **Last updated:** 04/18/2016