Individual
KAMAL C WAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01075433A
IN
207Q00000X
Family Medicine Physician
N9976
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
01075433A
IN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
25MA11879900
NJ
207QG0300X
Geriatric Medicine (Family Medicine) Physician
N9976
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201291250
—
IN
Enumeration date
02/03/2010
Last updated
04/02/2024
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