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1205839784

NPI Code Detail

MEDICARE: DR. GAIL B FAYRE M.D.

MEDICARE: DR. GAIL B FAYRE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	042.0015365	VT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	010122729	OTHER	NH	RAILROAD MEDICARE ID#

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0106222YPNH01	OTHER	NH	ANTHEM ID#
3	G33728	OTHER	NH	HARVARD PILGRIM ID #
4	222594672	OTHER	NH	GREATWEST HEALTHCARE ID#
5	2139311	OTHER	NH	CIGNA ID #
6	222594672	OTHER	NH	PRIVATE HEALTH CARE ID#
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	371551	OTHER	NH	MVP HEALTHCARE ID#
9	0106222Y0NH01	OTHER	NH	ANTHEM HFH ID#
10	222594672	OTHER	NH	HEALTH CARE VALUE MANAG#
11	3016256	OTHER	NH	AETNA ID#
12	H005016	OTHER	NH	TRICARE ID#
13	01-04592	OTHER	NH	UNITED HEALTHCARE ID#
14	371552	OTHER	NH	MVP HEALTHCARE HFH ID#

General Provider Information

NPI Number	:	1205839784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAIL B FAYRE M.D.

Provider Business Mailing Address
First Line	:	115 PORTER DR
Second Line	:
City	:	MIDDLEBURY
State	:	VT
Zip	:	05753-8629
Country	:	US
Telephone Number	:	802-388-4430
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 PORTER DR
Second Line	:
City	:	MIDDLEBURY
State	:	VT
Zip	:	05753-8629
Country	:	US
Telephone Number	:	802-388-4430
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	09/18/2025

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Directions to “ DR. GAIL B FAYRE M.D.” Practice Location

Language	Start Address	Practice Location

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