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Organization
PETER C. STICKNEY, MD PC
Active
Organization
PETER C. STICKNEY, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER C. STICKNEY MD (PRESIDENT)
(802) 773-2626
Entity
Organization
Contact information
Practice address
69 ALLEN ST, SUITE #5, RUTLAND, VT 05701-4590
(802) 773-2626
(802) 773-5245
Mailing address
69 ALLEN ST, SUITE #5, RUTLAND, VT 05701-4590
(802) 773-2626
(802) 773-5245
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0420004909
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004494
—
VT
Enumeration date
01/18/2013
Last updated
01/18/2013
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