Organization
WHITE RIVER FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK M NUNLIST (MD)
(802) 295-6132
Entity
Organization
Contact information
Practice address
331 OLCOTT DRIVE, SUITE U3, WHITE RIVER JCT, VT 05001
(802) 295-6132
(802) 295-1358
Mailing address
331 OLCOTT DRIVE, SUITE U3, WHITE RIVER JCT, VT 05001
(802) 295-6132
(802) 295-1358
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011112
—
VT
Enumeration date
11/22/2006
Last updated
03/29/2021
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