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Individual

FRED W KNIFFIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
115 PORTER DRIVE, PORTER HOSPITAL, MIDDLEBURY, VT 05753
(802) 388-4001
(802) 388-5612
Mailing address
115 PORTER DRIVE, 40 SUSAN SPITZNER FINANCE DEPT, MIDDLEBURY, VT 05753
(802) 388-5607
(802) 388-5654

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0420008090
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1008926
VT
01
360723
MVP VT MGD CARE
VT
01
58841
BCBS
VT
Enumeration date
09/08/2006
Last updated
07/09/2007
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