Ezra Demers

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Berlin, VT

NPI 1033075601 · NPPES record last updated Sep 11, 2026

Key facts

NPI
1033075601
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
License
097.0136421 (VT)
Practice address
174 Hospital Loop
Berlin, VT 05602-9105
Phone
(802) 479-4083
Fax
(802) 476-1476
NPI assigned
Dec 29, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 097.0136421 VT Yes

Addresses

Primary practice location

174 Hospital Loop
Berlin, VT 05602-9105

Mailing address

PO Box 647
Montpelier, VT 05601-0647
Phone (802) 479-4083

Other providers in Berlin, VT

All providers in Berlin, VT · Student in an Organized Health Care Education/Training Program in Vermont

Sources for this page

Verify at the official NPI Registry.