Individual
DEREK WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
20000 HARVARD AVE, WARRENSVILLE HEIGHTS, OH 44122-6805
(216) 491-6000
Mailing address
20000 HARVARD AVE, WARRENSVILLE HEIGHTS, OH 44122-6805
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/27/2026
Last updated
03/27/2026
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