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General NPI Number Information
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NPI Number | 1023238557
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Entity Type | Organization
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Legal Business Name | DAVID TOLL MD
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 01/25/2008
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Provider Practice Location Address
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Address Line | 1394 MAIN ST
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City | ST JOHNSBURY
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State | VT
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Zip | 05819-1829
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Country | US
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Telephone | 802-748-2348
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Fax | 802-748-5561
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Provider Business Mailing Address
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Address Line | 1394 MAIN ST
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City | ST JOHNSBURY
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State | VT
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Zip | 05819-1829
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Country | US
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Telephone | 802-748-2348
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Fax | 802-748-5561
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Authorized Official
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Title or Position | OWNER
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Name | DAVID TOLL
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Credential | MD
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Telephone | 802-748-2348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 042-0002104
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License Number State | VT
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