Provider Demographics
NPI:1982999728
Name:VANWAGENBERG, FRANS S (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANS
Middle Name:S
Last Name:VANWAGENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:930 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4312
Mailing Address - Country:US
Mailing Address - Phone:256-533-3388
Mailing Address - Fax:256-801-6905
Practice Address - Street 1:201 SIVLEY RD SW STE 300
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5102
Practice Address - Country:US
Practice Address - Phone:256-536-5594
Practice Address - Fax:256-533-3379
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10041442208600000X
AL38537208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgery