Amanda S Young, MD | |
115 Porter Drive, Middlebury, VT 05753 | |
(802) 388-5607 | |
(802) 388-5654 |
Full Name | Amanda S Young |
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Gender | Female |
Speciality | Emergency Medicine |
Location | 115 Porter Drive, Middlebury, Vermont |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073690426 | NPI | - | NPPES |
1015136 | Medicaid | VT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 017053 (Maine) | Secondary |
207P00000X | Emergency Medicine | 042-0011551 (Vermont) | Primary |
Entity Name | Porter Hospital Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134457013 PECOS PAC ID: 1850365180 Enrollment ID: O20050919000862 |
Mailing Address | Practice Location Address |
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Amanda S Young, MD 37 Porter Drive, Middlebury, VT 05753 Ph: (802) 388-4705 | Amanda S Young, MD 115 Porter Drive, Middlebury, VT 05753 Ph: (802) 388-5607 |
Jessica H Wagener, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 115 Porter Drive, Porter Hospital, Middlebury, VT 05753 Phone: 802-388-4001 Fax: 802-388-5612 | |
Robert D Pitts, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 115 Porter Dr, Porter Hospital, Middlebury, VT 05753 Phone: 802-388-4001 Fax: 802-388-5612 | |
Glen R Lovejoy, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 115 Porter Drive, Porter Hospital, Middlebury, VT 05753 Phone: 802-388-4001 Fax: 802-388-5612 | |
William J Nowlan, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 115 Porter Drive, Porter Hospital, Middlebury, VT 05753 Phone: 802-388-4001 Fax: 802-388-5612 | |
Fred W Kniffin, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 115 Porter Drive, Porter Hospital, Middlebury, VT 05753 Phone: 802-388-4001 Fax: 802-388-5612 | |
Robert Rene Gosselin, Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 6a Maple St, Middlebury, VT 05753 Phone: 724-991-3254 |