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Individual

ANGELA WINGATE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
209 WASHINGTON AVE, BENNINGTON, VT 05201-2312
(802) 442-0158
(802) 442-0160
Mailing address
209 WASHINGTON AVE, BENNINGTON, VT 05201-2312
(802) 442-0158
(802) 442-0160

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0420010148
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0049901
BC/BS
VT
01
08328
MVP
05
0VN2535
VT
01
10053531
CDPHP
01
50118000109
FIDELITY
01
5348525
CIGNA
01
7694525
AETNA
Enumeration date
07/28/2005
Last updated
07/08/2007
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