Individual
STEVEN WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3941
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
35-081437
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000192501
UNISON17
—
01
—
000000221396
UNISON
—
01
—
000000489288
ANTHEM17
—
01
—
000000509188
ANTHEM
OH
01
—
160057733
RAILROAD MEDICARE
OH
05
—
2346152
—
OH
01
—
364103
WELLCARE 29
OH
01
—
741765
BUCKEYE 29
OH
01
—
741765
WELLCARE
—
01
—
7866366
AETNA
OH
Enumeration date
07/05/2006
Last updated
11/22/2020
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