Individual
DR. MARY M BEERWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
147 ALLEN STREET, RUTLAND, VT 05701-4570
(802) 775-1901
(802) 773-2867
Mailing address
147 ALLEN ST, RUTLAND, VT 05701-4570
(802) 775-1901
(802) 773-2867
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
42-0007267
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10002440
CDPHP ID #
VT
01
—
16223
MVP ID #
VT
01
—
216-5217
BC/BS GROUP PROVIDER #
VT
01
—
216-5411
BC/BS INDIVIDUAL #
VT
05
—
VT9065
—
VT
Enumeration date
07/01/2005
Last updated
02/06/2012
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