Doctor Name: | PETER RICHARD NOBES |
NPI Number: | 1003976630 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | 055-0030117 |
Business Practice Address: | 32 Malletts Bay Ave Winooski, VT - 054041959 |
Business Phone Number: | 8026554422 |
Business Fax Number: | 8028612678 |
Mailing Address: | 7702 Spear St, CHARLOTTE |
State: | VT |
Postal Code: | 054458221 |
Phone Number: | 8024252260 |
Fax Number: | |
NPI Enumeration Date: | 12/12/2006 |
NPI Last Update Date: | 06/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 055-0030117 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |