Healthcare Provider Details

I. General information

NPI: 1952368011
Provider Name (Legal Business Name): ANDREW M ROBINSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 02/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 COUNTY RD
WINDSOR VT
05089-9000
US

IV. Provider business mailing address

289 COUNTY RD
WINDSOR VT
05089-9000
US

V. Phone/Fax

Practice location:
  • Phone: 802-674-7300
  • Fax: 802-674-7314
Mailing address:
  • Phone: 802-674-7300
  • Fax: 802-674-7314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number7489
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0420007741
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: