| Gene Moore Md P Llc | |
|
28 So Williams St Burlington VT 05401 | |
| (802) 864-7080 | |
| (802) 863-0411 |
| Full Name | Gene Moore Md P Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 28 So Williams St, Burlington, Vermont |
| Authorized Official Name and Position | Deb A Caise (OFFICE MANAGER) |
| Authorized Official Contact | 8028647080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gene Moore Md P Llc 28 S Williams St Burlington VT 05401-3486 Ph: (802) 864-7080 | Gene Moore Md P Llc 28 So Williams St Burlington VT 05401 Ph: (802) 864-7080 |
| NPI Number | 1437671377 |
|---|---|
| Provider Enumeration Date | 07/12/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 4183997687 |
|---|---|
| Medicare Enrollment ID | O20170905002890 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437671377 | NPI | - | NPPES |
| 00058102 | Other | VT | BLUE CROSS BLUE SHIELD |
| OVN2573 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 042010189 (Vermont) | Primary |
| Provider Name | Eugene F Moore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083677934 PECOS PAC ID: 2466576533 Enrollment ID: I20100825001107 |
| Provider Name | Sarah D Nadeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407120603 PECOS PAC ID: 5597929059 Enrollment ID: I20120613000152 |
| Provider Name | Nicholas A Fredette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710469481 PECOS PAC ID: 4183961253 Enrollment ID: I20190128001559 |
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