Healthcare Provider Details

I. General information

NPI: 1346688975
Provider Name (Legal Business Name): BENJAMIN I BEARNOT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2013
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 EXCHANGE ST STE 201
MIDDLEBURY VT
05753-4464
US

IV. Provider business mailing address

1330 EXCHANGE ST STE 201
MIDDLEBURY VT
05753-4464
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-0441
  • Fax:
Mailing address:
  • Phone: 802-388-0441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number267420
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL-255652
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: