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General NPI Number Information
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NPI Number | 1487124202
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Entity Type | Organization
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Legal Business Name | GORDON GIEG MD PLLC
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Dates
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Enumeration Date | 12/05/2018
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 5138 SHELBURNE RD
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City | SHELBURNE
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State | VT
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Zip | 05482-6698
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Country | US
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Telephone | 802-985-2585
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Fax | 802-985-5092
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Provider Business Mailing Address
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Address Line | PO BOX 850
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City | SHELBURNE
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State | VT
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Zip | 05482-0850
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Country | US
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Telephone | 802-985-2585
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Fax | 802-985-5092
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Authorized Official
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Title or Position | OWNER
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Name | DR. GORDON GEORGE GIEG
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Credential | MD
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Telephone | 802-985-2585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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