Healthcare Provider Details

I. General information

NPI: 1821213513
Provider Name (Legal Business Name): GOODHEALTH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

368 DORSET ST SUITE 2
SOUTH BURLINGTON VT
05403-6236
US

IV. Provider business mailing address

368 DORSET ST SUITE 2
SOUTH BURLINGTON VT
05403-6236
US

V. Phone/Fax

Practice location:
  • Phone: 802-860-7070
  • Fax: 802-860-7060
Mailing address:
  • Phone: 802-860-7070
  • Fax: 802-860-7060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. PETER G.S. GUNTHER
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 802-860-7070