Organization
NORTHWESTERN MEDICAL CENTER, INC.
Active
Other names
Northwestern Associates In Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PIGEON (CREDENTIALING SPECIALIST)
(802) 524-8954
Entity
Organization
Contact information
Practice address
1 CREST RD, SUITE B, SAINT ALBANS, VT 05478-9753
(802) 524-8974
(802) 524-8970
Mailing address
1 CREST RD, SUITE B, SAINT ALBANS, VT 05478-9753
(802) 524-8974
(802) 524-8970
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018505
—
VT
Enumeration date
12/03/2010
Last updated
10/23/2018
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