Individual
DR. NICHOLAS ROBERT BONENFANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2345
Mailing address
35 W ALLEN ST, APARTMENT F, WINOOSKI, VT 05404-2104
(603) 491-4732
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042-0014854
VT
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/21/2017
Last updated
07/02/2020
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