Organization
NORTHWEST MEDICAL SURGICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN R PAYNE M.D. (PRESIDENT)
(802) 524-2168
Entity
Organization
Contact information
Practice address
148 FAIRFIELD STREET, ST ALBANS, VT 05478
(802) 524-2168
(802) 524-0411
Mailing address
PO BOX 166, 148 FAIRFIELD STREET, SAINT ALBANS, VT 05478-0166
(802) 524-2168
(802) 524-0411
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
042-0007703
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28637
BLUE CROSS BLUE SHIELD
VT
Enumeration date
10/04/2006
Last updated
11/29/2012
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