Individual
PETER ALAN REDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 FISHER RD, HOSPITALIST PROGRAM, BERLIN, VT 05602-9516
(802) 225-1743
(802) 225-1745
Mailing address
PO BOX 547, ATT: CVMC FINANCE DEPT, BARRE, VT 05641-0547
(802) 225-1743
(802) 225-1745
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042.0011900
VT
207R00000X
Internal Medicine Physician
35626
WI
207RI0200X
Infectious Disease Physician
042.0011900
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017159
—
VT
01
—
P01338278
RAILROAD MEDICARE
VT
Enumeration date
04/19/2006
Last updated
12/04/2014
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