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Contact Information

WILFRED J FENNEWALD, LICENSED OPTICIAN
2737 NAVARRE AVE STE 204
OREGON, OH43616-3276
 Phone: 419-693-3376
 Fax: 419-693-7519
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optician

156FX1800X 96[5] Optician
 

Contact Lens Fitter

156FC0801X
Indicates primary specialty

NPI Profile & details for WILFRED J FENNEWALD · (Male)

NPI Number 1093790941
Status Active
Credentials LICENSED OPTICIAN
Entity Individual
Enumeration date 12/14/2005
Last updated 01/28/2019 - About 7 years ago
Sole proprietor 1 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(s) Not Available
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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