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General NPI Number Information
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NPI Number | 1467482356
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Entity Type | Organization
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Legal Business Name | WINDHAM OB-GYN ASSOCIATES, P.C.
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 387 CANAL ST
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City | BRATTLEBORO
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State | VT
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Zip | 05301-6616
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Country | US
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Telephone | 802-257-5807
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Fax | 802-257-9164
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Provider Business Mailing Address
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Address Line | 387 CANAL ST
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City | BRATTLEBORO
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State | VT
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Zip | 05301-6616
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Country | US
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Telephone | 802-257-5807
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Fax | 802-257-9164
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. BEV ROBINSON
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Credential |
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Telephone | 802-257-5807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0420006376
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License Number State | VT
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