Individual
DR. GAVIN L NOBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
61 COURT DR, BRANDON, VT 05733-8407
(802) 382-3443
Mailing address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-2811
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD26753
OR
207R00000X
Internal Medicine Physician
MD26753
OR
207RC0000X
Cardiovascular Disease Physician
042-0013148
VT
207RC0000X
Cardiovascular Disease Physician
Primary
MD26753
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00397411
MEDICARE RAILROAD
OR
05
—
028459
—
OR
Enumeration date
05/20/2006
Last updated
07/11/2023
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