George C Fjeld, MD

Individual provider Active NPI Family Medicine Physician · Brandon, VT

NPI 1720074743 · NPPES record last updated Aug 23, 2016

Key facts

NPI
1720074743
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
420006971 (VT)
Practice address
420 Grove St
Brandon, VT 05733-9062
Phone
(802) 247-6305
Fax
(802) 247-6040
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
420006971VTMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 420006971 VT Yes

Addresses

Primary practice location

420 Grove St
Brandon, VT 05733-9062

Mailing address

71 Allen St
Ste 403
Rutland, VT 05701-4570
Phone (802) 772-4414

Other identifiers

IdentifierTypeStateIssuer
04030324MedicaidNY
6049MedicaidVT

Other providers in Brandon, VT

All providers in Brandon, VT · Family Medicine Physician in Vermont

Sources for this page

Verify at the official NPI Registry.