Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 15342 | NH |
Y | 207RX0202X | Medical Oncology | 15342 | NH |
NPI | 1083639595 |
---|---|
Provider Name | Alexander D Fuld |
First Address | White River Junction, VT 05009-0001 |
Second Address | White River Junction, VT 05009-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I28279 | (02) |