Provider Demographics
NPI:1508804089
Name:GIDDINS, NIELS GEOFFREY (MD)
Entity Type:Individual
Prefix:
First Name:NIELS
Middle Name:GEOFFREY
Last Name:GIDDINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:VERMONT CHILDREN'S HOSPITAL AT FAHC
Mailing Address - Street 2:PATRICK 581, 111 COLCHESTER AVE.
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-847-8950
Mailing Address - Fax:802-847-7231
Practice Address - Street 1:VERMONT CHILDREN'S HOSPITAL AT FAHC
Practice Address - Street 2:PATRICK 581, 111 COLCHESTER AVE.
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-8950
Practice Address - Fax:802-847-7231
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA068486002080P0202X
VT042-00114772080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7848102Medicaid
NJ7848102Medicaid
NJ024229BVPMedicare ID - Type Unspecified