Individual
PETER HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
82 MAPLE STREET, ISLAND POND, VT 05846
(802) 723-4300
(802) 723-4544
Mailing address
165 SHERMAN DR, ST JOHNSBURY, VT 05819-9811
(802) 334-3504
(802) 334-3281
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042.0007993
VT
207R00000X
Internal Medicine Physician
0420007993
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00028804
BLUE SHIELD
VT
05
—
0009470
—
VT
01
—
110137555
RAILROAD MEDICARE
VT
05
—
3008260
—
NH
01
—
8000217
LADIES FIRST
VT
01
—
810628
MVP
VT
Enumeration date
08/30/2006
Last updated
06/17/2015
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