| Kyle L Wagamon, MD | |
|
2660 E Market St, Warren, OH 44483-6204 | |
| (330) 393-4000 | |
| (330) 392-5870 |
| Full Name | Kyle L Wagamon |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 23 Years |
| Location | 2660 E Market St, Warren, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780758003 | NPI | - | NPPES |
| 7474933 | Other | OH | AETNA |
| 000000217451 | Other | OH | UNISON |
| P00406585 | Other | OH | RAILROAD MEDICARE |
| 415051 | Other | OH | WELLCARE |
| 000000527821 | Other | OH | ANTHEM |
| 2754827 | Medicaid | OH | |
| 748956 | Other | OH | BUCKEYE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 35083746 (Ohio) | Secondary |
| 207ND0900X | Dermatology - Dermatopathology | 35083746 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mh St Joseph Warren Hospital | Warren, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Warren Dermatology And Mohs Surgery | 8628384070 | 5 |
| Entity Name | Warren Dermatology And Mohs Surgery |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033591813 PECOS PAC ID: 8628384070 Enrollment ID: O20150831000664 |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle L Wagamon, MD 19301 Cyclone Dr, Cleveland, OH 44135-1731 Ph: (330) 393-4000 | Kyle L Wagamon, MD 2660 E Market St, Warren, OH 44483-6204 Ph: (330) 393-4000 |
Dr. Indira Krishnarao, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 735 Niles Cortland Rd Se, Warren, OH 44484 Phone: 330-856-6365 Fax: 330-609-5088 | |
Rasnik Kaur Dulay, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1 American Way Ne, Warren, OH 44484 Phone: 330-856-8811 Fax: 330-856-8481 | |
Dr. Rachel Lynn Delost, DO Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2223 Niles Cortland Rd Se, Warren, OH 44484 Phone: 330-965-8760 Fax: 330-469-9706 | |
Morgan Hott, Dermatology Medicare: Accepting Medicare Assignments Practice Location: 735 Niles Cortland Rd Se, Warren, OH 44484 Phone: 330-856-6365 Fax: 330-474-3981 |