Healthcare Provider Details

I. General information

NPI: 1982702650
Provider Name (Legal Business Name): BETH ANN MAIER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 FISHER RD STE 1
BERLIN VT
05602-9179
US

IV. Provider business mailing address

36 RANDALL ST STE 1
WATERBURY VT
05676-1571
US

V. Phone/Fax

Practice location:
  • Phone: 802-371-5950
  • Fax:
Mailing address:
  • Phone: 802-244-7472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number042-0006268
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: