Organization
NORTHWESTERN MEDICAL CENTER, INC.
Active
Other names
Northwestern Dermatology
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, SAINT ALBANS, VT 05478-6058
(802) 524-9707
(802) 752-1361
Mailing address
128 FISHER POND RD, 2ND FLOOR, SAINT ALBANS, VT 05478-6058
(802) 524-9707
(802) 752-1361
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
08/17/2015
Last updated
10/23/2018
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