MEDICARE: DR. AMANDA DARE DURIGG HAGEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	260508-1	NY
2	2083P0901X	Public Health & General Preventive Medicine Physician	35.127648	OH
3	2083X0100X	Occupational Medicine Physician	04-39461	KS
4	208D00000X	General Practice Physician	C1-0007340	DE
5	2083X0100X	Occupational Medicine Physician	35.127648	OH

General Provider Information

NPI Number	:	1326019472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA DARE DURIGG HAGEN M.D.

Provider Business Mailing Address
First Line	:	CLEVELAND CLINIC AT WORK
Second Line	:	5595 TRANSPORTATION BLVD. #220
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125
Country	:	US
Telephone Number	:	216-587-5431
Fax Number	:	216-587-5474

Provider Business Practice Location Address
First Line	:	CLEVELAND CLINIC AT WORK
Second Line	:	5595 TRANSPORTATION BLVD. #220
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125
Country	:	US
Telephone Number	:	216-587-5431
Fax Number	:	216-587-5474

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	09/16/2019

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Directions to “ DR. AMANDA DARE DURIGG HAGEN M.D.” Practice Location

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