Edwin G Bovill, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

042-0006429 Issued in VT

Practice address

111 Colchester Ave
Fletcher Allen Health Care, Pathology
Burlington, VT 05401-1473

Phone

(802) 656-0359

Fax

(802) 656-8892

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184640377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 CLEARWATER RD",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054827725",
            "telephone_number": "802-985-8257",
            "fax_number": "802-656-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "FLETCHER ALLEN HEALTH CARE, PATHOLOGY",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-656-0359",
            "fax_number": "802-656-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVILL",
        "first_name": "EDWIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VT",
            "license": "042-0006429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00789859",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00789859",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Bouffard
• Gizelle Geva Medinaceli Boulter, PHARMD
• Richard B. Bounds, MD
• Barbara Fannie Boutsikaris, MS, LCMHC
• Erica Lynn Bove, MD
• Andrew Thomas Bowen, P.T.
• Beth Bowen, PT
• Courtney Ann Bowers, N.D.
• Samantha S Bowie, CAA
• Johanna D. Boyce, MSW

• Anatomic Pathology & Clinical Pathology Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Anatomic Pathology & Clinical Pathology Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.