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Individual

AMY E FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 GENERAL WING RD, CHCRR PEDIATRICS, RUTLAND, VT 05701-4681
(802) 773-9131
(802) 773-1551
Mailing address
71 ALLEN ST, STE 403, RUTLAND, VT 05701-4570
(802) 772-4414
(802) 772-7973

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042-0009717
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04312281
NY
05
1006417
VT
05
30200039
NH
Enumeration date
07/26/2006
Last updated
08/26/2016
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