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NPI Code Detail

MEDICARE: ANGELA WINGATE MD

MEDICARE:   ANGELA  WINGATE  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0420010148VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
150118000109OTHERFIDELITY
20049901OTHERVTBC/BS
37694525OTHERAETNA
410053531OTHERCDPHP
55348525OTHERCIGNA
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
708328OTHERMVP

General Provider Information

NPI Number : 1811997273
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA WINGATE MD
Provider Business Mailing Address
First Line : 209 WASHINGTON AVE
Second Line :
City : BENNINGTON
State : VT
Zip : 05201-2312
Country : US
Telephone Number : 802-442-0158
Fax Number : 802-442-0160
Provider Business Practice Location Address
First Line : 209 WASHINGTON AVE
Second Line :
City : BENNINGTON
State : VT
Zip : 05201-2312
Country : US
Telephone Number : 802-442-0158
Fax Number : 802-442-0160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 07/08/2007

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