Healthcare Provider Details

I. General information

NPI: 1215844519
Provider Name (Legal Business Name): KYLE DEWITT PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

26 OAK CREEK DR
SOUTH BURLINGTON VT
05403-7268
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-1237
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License Number033.0113678
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: