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Individual

JILL I BLUMBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
331 OLCOTT DR, SUITE U3, WHITE RIVER JUNCTION, VT 05001-9601
(802) 295-6132
Mailing address
331 OLCOTT DR, SUITE U3, WHITE RIVER JUNCTION, VT 05001-9601
(802) 295-6132

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0420012818
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1009068
VT
05
30203299
NH
Enumeration date
02/17/2006
Last updated
03/29/2021
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