National Provider Identifier Database

WILFRED J FENNEWALD, LICENSED OPTICIAN – NPI #1093790941
Optician

Contact Information

WILFRED J FENNEWALD, LICENSED OPTICIAN
2737 NAVARRE AVE STE 204
OREGON, OH  43616-3276
Phone: 419-693-3376
Fax: 419-693-7519
Website:
Specialty Taxonomy Code
* Optician 156FX1800X
Contact Lens Fitter 156FC0801X

* Indicates primary specialty

NPI Profile & details for WILFRED J FENNEWALD

NPI Number 1093790941
Credentials LICENSED OPTICIAN
Entity Individual
Enumeration date 12/14/2005
Last updated 01/28/2019 - About 7 years ago
Sole proprietor1 Yes
Identifiers
  • OH License #: SC2077
  • OH Medicaid: 0511637
  • OH Other: 000000155056 ANTHEM
  • OH Other: 31106091100 BWC
  • OH Other: OH2077 EYEMED
  • OH Other: 311060911001 MEDICAL MUTUAL
  • OH Other: 363492 NVA
  • OH Other: 10251 PARAMOUNT HEALTH CARE
  • OH Other: 15295 SPECTERA
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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