MEDICARE: ANGELA L 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
1	207Q00000X	Family Medicine Physician	0420010148	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	50118000109	OTHER	VT	FIDELIS
3	00029207	OTHER	VT	BLUE CROSS BLUE SHIELD
4	10053531	OTHER	VT	CDPHP
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	319096	OTHER	VT	MVP
7	5348525	OTHER	VT	CIGNA
8	7694525	OTHER	VT	AETNA
9	08328	OTHER	VT	MVP
10	415181	OTHER	VT	LADIES FIRST
11	4849277	OTHER	VT	CIGNA
12	8000201	OTHER	VT	LADIES FIRST
13	00049901	OTHER	VT	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1902941917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELA L 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	:	SOLE PROPRIETOR
Name	:	DR. ANGELA LYNN WINGATE
Credential	:	MD
Telephone Number	:	802-442-0158

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	08/22/2020

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Directions to “ANGELA L WINGATE MD ” Practice Location

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