Organization
MAD RIVER INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY J WARGO M.D. (PARTNER)
(802) 496-2202
Entity
Organization
Contact information
Practice address
5360 MAIN ST, STE. 2, WAITSFIELD, VT 05673-6003
(802) 496-2202
(802) 496-2223
Mailing address
5360 MAIN ST, STE. 2, WAITSFIELD, VT 05673-6003
(802) 496-2202
(802) 496-2223
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012198
—
VT
Enumeration date
03/17/2006
Last updated
08/22/2020
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