Individual
BRENT M WOGAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
719 W HAMILTON AVE, SUITE C, EAU CLAIRE, WI 54701-6968
(715) 832-1044
(715) 832-0520
Mailing address
719 W HAMILTON AVE, SUITE C, EAU CLAIRE, WI 54701-6968
(715) 832-1044
(715) 832-0520
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
36446
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020031295
RAILROAD MEDICARE
WI
01
—
17-13730
SELECT CARE/MEDICA
WI
05
—
32105900
—
WI
01
—
38718
SECURITY HEALTH PLAN
WI
01
—
HP60437
HEALTH PARTNERS
WI
Enumeration date
05/04/2006
Last updated
12/17/2021
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