Individual
DR. RICHARD ANDREW BURGOYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 S MAIN ST, WATERBURY, VT 05676-1519
(802) 244-7874
(802) 244-4106
Mailing address
PO BOX 547, CENTRAL VERMONT MEDICAL CENTER - FINANCE DEPT, BARRE, VT 05641-0547
(802) 244-7874
(802) 244-4106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0420011847
VT
207Q00000X
Family Medicine Physician
D0042816
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016787
—
VT
05
—
751121300
—
MD
Enumeration date
07/03/2006
Last updated
12/04/2014
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