Wagner, Beth Ellen
Wagner, Beth Ellen is an individual health care provider with primary practice located at 130 Fisher Rd Hospitalist Program, Berlin VT 05602-9516. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Wagner, Beth Ellen can be contacted via phone (802) 225-1743.Contact Information
Primary practice address
130 Fisher Rd Hospitalist Program
Berlin VT 05602-9516
Phone: (802) 225-1743
Fax: (802) 225-1745
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 5247 | Alaska |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 032.0095970 | Vermont |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 032.0095970 | Vermont |
Profile Details
| NPI number | 1871720482 |
|---|---|
| LBN Legal business name | Wagner, Beth Ellen |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2009 |
| Last updated | Dec 4th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871720482 | NPPES |
| Vermont | MEDICAID | 1022074 | |
| Vermont | MEDICAID | MD0914 |
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