MEDICARE: AICHETOU B WAIGA DO

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	207Q00000X	Family Medicine Physician	34.018017	OH

General Provider Information

NPI Number	:	1871235267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AICHETOU B WAIGA DO

Provider Business Mailing Address
First Line	:	PO BOX 7527
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-0727
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 W WATERLOO ST STE 210B
Second Line	:
City	:	CANAL WINCHESTER
State	:	OH
Zip	:	43110-1005
Country	:	US
Telephone Number	:	614-955-3430
Fax Number	:	614-533-0465

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

Provider Enumeration Date	:	04/07/2022
Last Update Date	:	05/28/2026

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Directions to “ AICHETOU B WAIGA DO” Practice Location

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