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General NPI Number Information
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NPI Number | 1770886715
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Entity Type | Organization
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Legal Business Name | DEIRDRE H. DONALDSON, M.D., PLC
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Dates
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Enumeration Date | 12/14/2010
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Last Update Date | 12/14/2010
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Provider Practice Location Address
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Address Line | 19 BELMONT AVE SUITE 104
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City | BRATTLEBORO
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State | VT
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Zip | 05301-7109
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Country | US
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Telephone | 802-258-6590
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Fax | 802-258-6525
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Provider Business Mailing Address
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Address Line | 19 BELMONT AVE SUITE 104
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City | BRATTLEBORO
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State | VT
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Zip | 05301-7109
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Country | US
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Telephone | 802-258-6590
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Fax | 802-258-6525
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEIRDRE H DONALDSON
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Credential | M.D., PHD
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Telephone | 802-258-6590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 042-0009619
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License Number State | VT
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