Individual
GREGORY J MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 FISHER RD, MOB- A SUITE 2-1, BERLIN, VT 05602-9516
(802) 225-5660
(802) 229-2533
Mailing address
PO BOX 547, CENTRAL VERMONT MEDICAL CENTER-FINANCE DEPT, BARRE, VT 05641-0547
(802) 225-5660
(802) 229-9533
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
042.0006170
VT
207RI0011X
Interventional Cardiology Physician
420006170
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004794
—
VT
01
—
060014974
RAIL ROAD MEDICARE
VT
01
—
P01125401
RAILROAD MEDICARE LINKED TO CVMC MGP
VT
Enumeration date
07/19/2006
Last updated
12/04/2014
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