Organization
BRISTOL INTERNAL MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN J MULHOLLAND MD (PRESIDENT, MED DIRECTOR)
(802) 453-7422
Entity
Organization
Contact information
Practice address
6 PARK PL, BRISTOL, VT 05443-1229
(802) 453-7422
Mailing address
PO BOX 415, BRISTOL, VT 05443-0415
(802) 453-7422
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN3487
—
VT
01
—
68277
BC BS OF VT
VT
Enumeration date
05/19/2006
Last updated
08/22/2020
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