Individual
DR. PETTER ANDRE VAAGENES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1320 W MAIN ST, NEWARK, OH 43055-1822
(220) 564-4144
(220) 564-7153
Mailing address
1320 W MAIN ST, NEWARK, OH 43055-1822
(220) 564-4144
(220) 564-7153
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34.009309
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2933151
—
OH
Enumeration date
05/15/2007
Last updated
03/15/2017
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