NPI 1679042196 · live from the CMS NPI Registry
Matthew Maya
Radiology, Diagnostic Radiology in White River Junction, VT. National Provider Identifier 1679042196, active.
NPI record
| NPI | 1679042196 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 163 Veterans Dr, White River Junction, VT 05009 |
| Practice phone | 802-295-9363 |
| Mailing address | 1869 Pomfret Rd, Woodstock, VT 05091 |
| Enumerated | November 14, 2018 |
| Last updated | November 14, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology primary | 2085R0202X | 447680 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.