Provider Demographics
NPI:1386933869
Name:WAJDA, AGATA (MD)
Entity type:Individual
Prefix:DR
First Name:AGATA
Middle Name:
Last Name:WAJDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AGATA
Other - Middle Name:
Other - Last Name:SLOSAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 2008
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-7966
Mailing Address - Fax:513-636-7967
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 2008
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-7966
Practice Address - Fax:513-636-7967
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.123325208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics