Provider Demographics
NPI:1487838868
Name:GOODHEALTH DIAGNOSTIC CENTER, INC.
Entity Type:Organization
Organization Name:GOODHEALTH DIAGNOSTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:G
Authorized Official - Last Name:GUNTHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-860-7070
Mailing Address - Street 1:368 DORSET ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6236
Mailing Address - Country:US
Mailing Address - Phone:802-860-7070
Mailing Address - Fax:802-860-7060
Practice Address - Street 1:368 DORSET ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6236
Practice Address - Country:US
Practice Address - Phone:802-860-7070
Practice Address - Fax:802-860-7060
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOODHEALTH DIAGNOSTIC CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1013797Medicaid
VT1013797Medicaid