Individual
JOHN R WIGNESWARAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
455 TURNER RD, DAYTON, OH 45415-3630
(937) 208-7930
(937) 222-7910
Mailing address
1 ELIZABETH PL, SUITE 190, DAYTON, OH 45408-1445
(937) 222-3118
(937) 222-1436
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
080805
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221825
ANTHEM
—
05
—
2306918
—
OH
01
—
2809872
AETNA
—
01
—
310821503033
MEDICARE RAILROAD
—
01
—
3108215037021
UNITED MINE WORKERS
—
01
—
3120003
UHC
—
01
—
D80805
HUMANA
—
Enumeration date
11/23/2005
Last updated
07/08/2007
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