Individual
DR. LEE S WAGMEISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4015 GATEWAY BLVD, SUITE 2120, NEWBURGH, IN 47630-8925
(812) 842-0907
(812) 464-0536
Mailing address
4015 GATEWAY BLVD STE 2120, NEWBURGH, IN 47630-8925
(812) 492-5457
(812) 464-4485
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01052501A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
36924
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000174053
ANTHEM
—
01
—
0000475621-01
WELBORN HEALTH PLANS
—
05
—
200267590
—
IN
01
—
330005278
IN RR MCR
—
01
—
438544
HEALTHLINK
—
05
—
64024532
—
KY
01
—
832011P
SIHO
—
Enumeration date
05/03/2006
Last updated
05/17/2016
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