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General NPI Number Information
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NPI Number | 1477494565
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Entity Type | Individual
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Provider Name | ANGEL WYNN MAGETTE RDH
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 9159 FRANKTOWN ROAD
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City | FRANKTOWN
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State | VA
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Zip | 23354
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Country | US
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Telephone | 757-414-0400
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Fax | 757-414-0569
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Provider Business Mailing Address
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Address Line | 9068 BIRDSNEST DR
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City | BIRDSNEST
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State | VA
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Zip | 23307-1426
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Country | US
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Telephone | 757-999-4110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0402004136
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License Number State | VA
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