NPI 1518984541

Hans Peter Diercksen, MD

Practitioner Family Medicine Physician Bomoseen, VT

Practice location

Address: 275 Route 30 N, Bomoseen, VT 05732-9647
Phone: (802) 468-5641
Fax: (802) 468-2923
Mailing address: 71 Allen St STE 101, Rutland, VT 05701-4570

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 0420006786 (VT)

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Registry record

NPI: 1518984541
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Jul 2006
Record last updated: 29 Nov 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.