Provider Demographics
NPI:1487993143
Name:WOHLHAGEN, JAMIE (OD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:WOHLHAGEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 SILVERSIDE RD
Mailing Address - Street 2:NAAMANS BLDG.
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4910
Mailing Address - Country:US
Mailing Address - Phone:302-479-3937
Mailing Address - Fax:302-477-2653
Practice Address - Street 1:3501 SILVERSIDE RD
Practice Address - Street 2:NAAMANS BLDG.
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4910
Practice Address - Country:US
Practice Address - Phone:302-479-3937
Practice Address - Fax:302-477-2653
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI3-0001358152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist