# NORTHWESTERN MEDICAL CENTER, INC.

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

## Provider details

- **NPI number:** 1376140889
- **Authorized official:** MARY E PIGEON (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (802) 524-8954

## Contact information

- **Practice address:** 133 FAIRFIELD ST STE 103A, SAINT ALBANS, VT 05478-1726
- **Practice address phone:** (802) 527-8189
- **Practice address fax:** (802) 527-8187
- **Mailing address:** 133 FAIRFIELD ST, SAINT ALBANS, VT 05478-1726
- **Mailing address phone:** (802) 527-8189
- **Mailing address fax:** (802) 527-8187

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2020
- **Last updated:** 10/12/2020