Mr. Philip Wagenbach, PA-C
Mr. Philip Wagenbach, PA-C is a Physician Assistant in Bomoseen, Vermont. Qualified in 2005, 21 years ago. Practices with Community Health Centers of the Rutland Region Inc, a 102-clinician group and accepts Medicare assignment. Licensed in Connecticut and Vermont.
- Years since qualifying
- 21
- Licensed in
- CT, VT
- In the registry since
- 2006
- Specialties on file
- 2
What do these letters mean?
- PA-C — Physician Assistant, Certified
- A physician assistant who holds current national certification.
Practice location Address checks out
275 Route 30 NBomoseen, VT 05732-9647
Phone: (802) 468-5641
Fax: (802) 468-2923
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Medical Physician Assistant (primary) | Taxonomy 363AM0700X · Licence 055-0031268 (VT) |
|---|---|
| Physician Assistant | Taxonomy 363A00000X · Licence 001695 (CT) |
Record details
| NPI number | 1790797116 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA-C |
| Sole proprietor | No |
| NPI enumerated | August 13, 2006 |
| Last updated in NPPES | October 5, 2015 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2005 (21 years in practice) |
| Group practice | Community Health Centers Of The Rutland Region Inc — 102 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
Other providers in Bomoseen
-
Samuel Joseph Cahill, PA-C
275 Route 30 N, Bomoseen, VT 05732-9647 · (802) 468-5641