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General NPI Number Information
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NPI Number | 1053288209
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Entity Type | Organization
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Legal Business Name | MAPLE RUN PRIMARY CARE PLLC
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 134 MAIN ST
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City | MONTPELIER
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State | VT
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Zip | 05602-2913
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Country | US
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Telephone | 802-341-8775
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Fax | 844-689-3199
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Provider Business Mailing Address
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Address Line | 134 MAIN ST
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City | MONTPELIER
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State | VT
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Zip | 05602-2913
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Country | US
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Telephone | 802-341-8775
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Fax | 844-689-3199
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. BRIAN L RODRIGUEZ
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Credential | MD
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Telephone | 802-477-2707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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