Fennewald, Wilfred James

Fennewald, Wilfred James is an sole proprietor health care provider with primary practice located at 2737 Navarre Ave Ste 204 , Oregon OH 43616-3276. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Contact Lens Fitter, Eye and Vision Services Providers / Optician. Eye and Vision Services Providers / Optician is his primary health care specialty. Fennewald, Wilfred James can be contacted via phone (419) 693-3376.

Contact Information

Primary practice address
2737 Navarre Ave Ste 204 Oregon OH 43616-3276
Phone: (419) 693-3376
Fax: (419) 693-7519
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Contact Lens Fitter 156FC0801X SC2077 Ohio
Eye and Vision Services Providers / Optician 156FX1800X SC2077 Ohio

Profile Details

NPI number 1093790941
LBN Legal business name Fennewald, Wilfred James
Credentials LICENSED OPTICIAN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 14th, 2005
Last updated Jan 28th, 2019 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093790941 NPPES
Ohio Other 363492 NVA
Ohio Other OH2077 NVA
Ohio MEDICAID 0511637 NVA
Ohio Other 31106091100 NVA
Ohio Other 000000155056 NVA
Ohio Other 10251 NVA
Ohio Other 311060911001 NVA
Ohio Other 15295 NVA

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