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General NPI Number Information
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NPI Number | 1144314196
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Entity Type | Organization
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Legal Business Name | DENISE A. NIEMIRA, M.D., P.C.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5452 US ROUTE 5 STE. D
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City | NEWPORT
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State | VT
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Zip | 05855-9870
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Country | US
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Telephone | 802-334-6140
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Fax | 802-334-8271
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Provider Business Mailing Address
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Address Line | 5452 US ROUTE 5 STE. D
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City | NEWPORT
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State | VT
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Zip | 05855-9870
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Country | US
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Telephone | 802-334-6140
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Fax | 802-334-8271
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DENISE AILEEN NIEMIRA
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Credential | M.D.
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Telephone | 802-334-6140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | VT
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