Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD028760E | PA |
NPI | 1083676191 |
---|---|
Provider Name | William Hagberg |
First Address | Wexford, PA 15090-7380 |
Second Address | Wexford, PA 15090-7380 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 05/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0010906100006 | (05) | PA |
081148 | BLUE CROSS/BLUE SHIELD (01) | PA |
1009963 | GATEWAY HEALTH PLAN (01) | PA |
200038714 | RAILROAD MEDICARE (01) | PA |
233298 | HEALTHAMERICAN/HEALTHASSURANCE (01) | PA |
248052 | BLUE SHIELD - DME (01) | PA |
25180380900 | WV WORKERS COMPENSATION (01) | WV |
4086272 | AETNA (01) | PA |
C29249 | (02) | PA |