Healthcare Provider Details

I. General information

NPI: 1962039693
Provider Name (Legal Business Name): BRENDAN MURPHY CAMPBELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

3023 GREENBUSH RD
CHARLOTTE VT
05445-9313
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-2345
  • Fax:
Mailing address:
  • Phone: 203-984-7554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number336917
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number042.0018515
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: