DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. PHILIP WAGENBACH, PA-C

Active

MR. PHILIP WAGENBACH, PA-C is a Medical Physician Assistant healthcare provider located in BOMOSEEN, Vermont. NPI 1790797116 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · BOMOSEEN, VT

Registration Details

NPI Number
1790797116
Provider Type
Individual
Gender
Male
NPI Issued
Aug 13, 2006 (19.964153768149 yrs)
Last Updated
Oct 5, 2015
Licenses
001695 (CT)
055-0031268 (VT)

Practice Information

Address
275 ROUTE 30 N
BOMOSEEN, VT, 057329647
Browse VT providers · Browse ZIP 05732
Phone
8024685641
Fax
8024682923
Primary Specialty
Medical Physician Assistant
363AM0700X
Additional Specialty
Medical Physician Assistant

Other Medical Physician Assistant Providers in BOMOSEEN, VT

Name Credential NPI
PAULINE KAHNG PA 1396748489
MS. SARAH STORK TATKO PA 1598908683
KATELYN DORAN BELDEN PA-C 1659713683
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.