Individual
BRENDA L HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
34004110
OH
207L00000X
Anesthesiology Physician
Primary
36203
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0636162
—
OH
Enumeration date
03/09/2006
Last updated
11/16/2016
Update your record
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