Healthcare Provider Details

I. General information

NPI: 1265515910
Provider Name (Legal Business Name): GEORGE P. TERWILLIGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 03/07/2023
Certification Date: 11/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 GRAFTON RD
TOWNSHEND VT
05353-8820
US

IV. Provider business mailing address

PO BOX 216
TOWNSHEND VT
05353-0216
US

V. Phone/Fax

Practice location:
  • Phone: 802-365-3725
  • Fax: 603-354-6605
Mailing address:
  • Phone: 802-451-6916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11293
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: