Organization
NORTHWESTERN MEDICAL CENTER, INC.
Active
Other names
Northwestern Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PIGEON (CREDENTIALING SPECIALIST)
(802) 524-8954
Entity
Organization
Contact information
Practice address
260 CREST RD, SAINT ALBANS, VT 05478-9503
(802) 524-8805
(802) 524-8488
Mailing address
133 FAIRFIELD ST, SAINT ALBANS, VT 05478-1726
(802) 524-5911
(802) 527-1057
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017547
—
VT
Enumeration date
04/28/2010
Last updated
08/27/2021
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