MEDICARE: CLIFFORD BARRY LANGWEILER 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	042-0007892	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	08P335	OTHER	VT	MVP
2	00005366	OTHER	VT	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952308835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLIFFORD BARRY LANGWEILER MD

Provider Business Mailing Address
First Line	:	15 BELMONT AVE
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-6613
Country	:	US
Telephone Number	:	802-258-2664
Fax Number	:	802-258-2570

Provider Business Practice Location Address
First Line	:	15 BELMONT AVE
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-6613
Country	:	US
Telephone Number	:	802-258-2664
Fax Number	:	802-258-2570

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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