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General NPI Number Information
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NPI Number | 1184465957
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Entity Type | Organization
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Legal Business Name | JAGEMAN NAD JAGEMAN MDS INC
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 4108 ZUCK RD
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City | ERIE
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State | PA
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Zip | 16506-4539
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Country | US
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Telephone | 814-392-2745
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Fax |
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Provider Business Mailing Address
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Address Line | 6002 BOXWOOD DR
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City | FAIRVIEW
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State | PA
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Zip | 16415-3220
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Country | US
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Telephone | 814-392-2745
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN C JAGEMAN
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Credential | MD
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Telephone | 814-392-2745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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