Organization
NORTHWESTERN MEDICAL CENTER, INC.
Active
Other names
Northwestern Ophthalmology
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E PIGEON (CREDENTIALING SPECIALIST)
(802) 524-8954
Entity
Organization
Contact information
Practice address
128 FISHER POND RD, 2ND FLOOR, SUITE 3, SAINT ALBANS, VT 05478-6058
(802) 752-1921
(802) 752-1356
Mailing address
128 FISHER POND ROAD, 2ND FLOOR, SUITE 3, SAINT ALBANS, VT 05478-4405
(802) 752-1921
(802) 752-1356
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020384
—
VT
Enumeration date
04/04/2012
Last updated
10/23/2018
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