NPI 1063469419 · live from the CMS NPI Registry
Walter Wagenknecht, MD
Radiology, Diagnostic Radiology in Brattleboro, VT. National Provider Identifier 1063469419, active.
NPI record
| NPI | 1063469419 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 17 Belmont Ave, Brattleboro, VT 05301 |
| Practice phone | 800-655-3603 |
| Mailing address | Po Box 910, Greenfield, MA 01302 |
| Enumerated | May 30, 2006 |
| Last updated | January 30, 2009 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology primary | 2085R0202X | 0420010063 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.