Todd Emmit Wagner, MD | |
21100 Southgate Park Blvd, Maple Heights, OH 44137-3004 | |
(216) 663-6100 | |
(216) 395-1071 |
Full Name | Todd Emmit Wagner |
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Gender | Male |
Speciality | Family Medicine |
Location | 21100 Southgate Park Blvd, Maple Heights, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063674299 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 35.099746 (Ohio) | Primary |
Entity Name | Signature Health, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679767289 PECOS PAC ID: 8628970985 Enrollment ID: O20040126000762 |
Mailing Address | Practice Location Address |
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Todd Emmit Wagner, MD 21100 Southgate Park Blvd, Maple Heights, OH 44137-3004 Ph: (216) 663-6100 | Todd Emmit Wagner, MD 21100 Southgate Park Blvd, Maple Heights, OH 44137-3004 Ph: (216) 663-6100 |
Eugene S Balkovec, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 15003 Turney Rd, Maple Heights, OH 44137 Phone: 216-640-9525 | |
David D Mccarther, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 5264 Lee Rd, Maple Heights, OH 44137 Phone: 216-294-4440 Fax: 216-249-6032 | |
Vadhya Elivert, D.O Family Medicine Medicare: Medicare Enrolled Practice Location: 5264 Lee Rd Ste 108, Maple Heights, OH 44137 Phone: 216-294-4440 Fax: 216-249-6032 | |
Dr. Diane Marie Kushnar, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 5264 Lee Rd, Maple Heights, OH 44137 Phone: 216-294-4440 | |
Dr. Angela M Bennett, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 5264 Lee Rd, Maple Heights, OH 44137 Phone: 216-294-4440 Fax: 216-249-6032 | |
Dale A Balkovec, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15003 Turney Rd, Maple Heights, OH 44137 Phone: 216-663-7753 Fax: 216-663-0897 |