Organization · Type 2 NPI
Vineyard Personalized Medicine LLC
General Practice Physician · West Tisbury, MA
NPI number
1275894875
Active
Practice location
24 Cournoyer Rd
West Tisbury, MA 02575
Fax (508) 693-1305
Mailing address
24 Cournoyer Rd
Vineyard Haven, MA 02568-7625
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | 72590 (MA) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
About NPI 1275894875
Vineyard Personalized Medicine LLC's National Provider Identifier is 1275894875, issued on May 31, 2012. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in West Tisbury, MA. The record was last updated on Nov 25, 2015.