# BEVERLY J. ROSEBERRY, MD, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265692453
- **Authorized official:** MRS. BEVERLY JEAN ROSEBERRY MD (OWNER)
- **Authorized official phone:** (802) 779-0114

## Contact information

- **Practice address:** 11 COMMONS ST, RUTLAND, VT 05701-4652
- **Practice address phone:** (802) 779-0114
- **Practice address fax:** (802) 779-0123
- **Mailing address:** 11 COMMONS ST, RUTLAND, VT 05701-4652
- **Mailing address phone:** (802) 779-0114
- **Mailing address fax:** (802) 779-0123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 042-0011545 | VT | Yes |

## Other

- **Enumeration date:** 06/11/2008
- **Last updated:** 10/09/2009