Individual
WENDY AMBER FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1315 HOSPITAL DRIVE, ST. JOHNSBURY, VT 05819
(989) 731-7987
Mailing address
1315 HOSPITAL DRIVE, ST. JOHNSBURY, VT 05819
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301082602
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0206910342
BCBSM PROVIDER NUMBER
MI
01
—
0F96004
MEDICARE GROUP ID
MI
01
—
11276527
CAQH PROVIDER ID
—
05
—
4785784
—
MI
01
—
CC4805
MEDICARE RR PROV ID
—
Enumeration date
07/03/2006
Last updated
10/24/2019
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