Individual provider · NPI-1

Benjamin Joseph Depo, MD

Hospitalist · Burlington, VT

NPI number1093219461

StatusActive

Last updated in NPPESJul 7, 2021

Details

NPI: 1093219461
Entity type: Individual (NPI-1)
Name: Mr. Benjamin Joseph Depo
Credential: MD
Sex: Male
Sole proprietor: No
Enumeration date: Mar 21, 2018
Certification date: Jul 7, 2021
Last updated: Jul 7, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208M00000X	Hospitalist	042-0015342	VT	Yes
207R00000X	Internal Medicine	042-0015342	VT
390200000X	Student in an Organized Health Care Education/Training Program	–	–

Practice location

111 Colchester Ave
Burlington, VT 05401-1473

Phone 802-847-2345

Mailing address

67 Kennedy Rd
Cadyville, NY 12918-3312

Phone 518-420-5565

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