Provider Demographics
NPI:1982702650
Name:MAIER, BETH ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:BETH ANN
Middle Name:
Last Name:MAIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 RANDALL ST
Mailing Address - Street 2:STE 1
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05676-1571
Mailing Address - Country:US
Mailing Address - Phone:802-244-7472
Mailing Address - Fax:
Practice Address - Street 1:266 FISHER RD
Practice Address - Street 2:STE 1
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9179
Practice Address - Country:US
Practice Address - Phone:802-371-5950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0006268208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTD03203Medicare UPIN