Healthcare Provider Details

I. General information

NPI: 1215159579
Provider Name (Legal Business Name): TERENCE DWIGHT NAUMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 TILDEN AVE
RICHMOND VT
05477-4400
US

IV. Provider business mailing address

127 TILDEN AVE
RICHMOND VT
05477-4400
US

V. Phone/Fax

Practice location:
  • Phone: 802-434-5006
  • Fax:
Mailing address:
  • Phone: 802-434-5006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7003
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: