Wagner, Katherine Mary
Wagner, Katherine Mary is an individual health care provider with primary practice located at 13201 Granger Rd Ste 2 , Garfield Hts OH 44125-1979. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Wagner, Katherine Mary can be contacted via phone (216) 475-8844.Contact Information
Primary practice address
13201 Granger Rd Ste 2
Garfield Hts OH 44125-1979
Phone: (216) 475-8844
Fax: (216) 475-3816
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35-096862 | Ohio |
Profile Details
| NPI number | 1396908265 |
|---|---|
| LBN Legal business name | Wagner, Katherine Mary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 9th, 2008 |
| Last updated | Dec 19th, 2011 - about 13 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 | 1396908265 | NPPES |
| Ohio | MEDICAID | 3149168 |
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