Engstrom, Conley Walter
Engstrom, Conley Walter is an individual health care provider with primary practice located at 26908 Detroit Rd Suite 103, Westlake OH 44145-2398. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Engstrom, Conley Walter can be contacted via phone (440) 482-8323.Contact Information
Primary practice address
26908 Detroit Rd Suite 103
Westlake OH 44145-2398
Phone: (440) 482-8323
Fax: (440) 808-1606
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 042542 | Ohio |
Profile Details
| NPI number | 1518949551 |
|---|---|
| LBN Legal business name | Engstrom, Conley Walter |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2005 |
| Last updated | Jan 7th, 2020 - about 5 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 | 1518949551 | NPPES |
| Ohio | MEDICAID | 0466339 |
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