Individual
ROBERT CHARLES JIMERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0420006257
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004518
—
VT
01
—
VT4518
MEDICARE ID - TYPE UNSPECIFIED
VT
Enumeration date
03/08/2007
Last updated
02/08/2012
Update your record
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