Healthcare Provider Details
I. General information
NPI: 1013237536
Provider Name (Legal Business Name): BENJAMIN NOLIN STEPP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/07/2010
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1068 UNION ST
BANGOR ME
04401-3016
US
IV. Provider business mailing address
111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US
V. Phone/Fax
- Phone: 207-404-8181
- Fax: 207-922-4198
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 2012-00969 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 042.0018833 |
| License Number State | VT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: