Provider Demographics
NPI:1013102466
Name:BRILLHART, AARON MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:MARTIN
Last Name:BRILLHART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:UNDERHILL
Mailing Address - State:VT
Mailing Address - Zip Code:05489-0001
Mailing Address - Country:US
Mailing Address - Phone:907-982-4124
Mailing Address - Fax:
Practice Address - Street 1:133 FAIRFIELD ST
Practice Address - Street 2:NORTHWESTERN MEDICAL CENTER
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-1726
Practice Address - Country:US
Practice Address - Phone:802-524-5911
Practice Address - Fax:802-371-4481
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0012431207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT002875202OtherMEDICARE PTAN LINKED TO CVMC
VT1020811Medicaid