Individual
KYLE L WAGAMON
Active
Individual
KYLE L WAGAMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
35083746
OH
207ND0900X
Dermatopathology Physician
Primary
35083746
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000217451
UNISON
OH
01
—
000000527821
ANTHEM
OH
05
—
2754827
—
OH
01
—
415051
WELLCARE
OH
01
—
7474933
AETNA
OH
01
—
748956
BUCKEYE
OH
01
—
P00406585
RAILROAD MEDICARE
OH
Enumeration date
11/20/2006
Last updated
03/27/2026
Update your record
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