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Individual

DR. KAREN SUE WAGENHALS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(419) 526-8486
Mailing address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(419) 526-8486

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35-041504
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2289161
OH
Enumeration date
10/13/2006
Last updated
07/08/2007
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