Gibbons, Peter Douglas

Gibbons, Peter Douglas is an sole proprietor health care provider with primary practice located at 17 Belmont Ave , Brattleboro VT 05301. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Gibbons, Peter Douglas can be contacted via phone (802) 257-0115.

Contact Information

Primary practice address
17 Belmont Ave Brattleboro VT 05301
Phone: (802) 257-0115
Fax: (802) 257-8849
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 042-0004180 Vermont

Profile Details

NPI number 1639239312
LBN Legal business name Gibbons, Peter Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 11th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639239312 NPPES
Vermont Other 00004779 BLUE SHIELD
Vermont Other 03-0239725 BLUE SHIELD
Vermont MEDICAID 0004779 BLUE SHIELD

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