Provider Demographics
NPI:1366433260
Name:NOBLE, VICKI E (MD)
Entity type:Individual
Prefix:DR
First Name:VICKI
Middle Name:E
Last Name:NOBLE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:CLN 115
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-5655
Practice Address - Fax:617-724-0917
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2017-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA210271207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA210271OtherTUFTS HEALTH PLAN
MAJ25824OtherBCBS MA
MA2001144Medicaid
MAJ25824OtherBCBS MA
MA2001144Medicaid