Wagenberg, Scott Alan

Wagenberg, Scott Alan is an individual health care provider with primary practice located at 6770 Mayfield Rd Suite 326, Mayfield Hts OH 44124-2299. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Wagenberg, Scott Alan can be contacted via phone (440) 461-4733.

Contact Information

Primary practice address
6770 Mayfield Rd Suite 326 Mayfield Hts OH 44124-2299
Phone: (440) 461-4733
Fax: (440) 461-4049
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 35078327 Ohio

Profile Details

NPI number 1821020447
LBN Legal business name Wagenberg, Scott Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Jul 8th, 2007 - about 19 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 1821020447 NPPES
Ohio MEDICAID 2209363

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