Waggonner, David Bryan

Waggonner, David Bryan is an individual health care provider with primary practice located at 6500 Excelsior Blvd , Saint Louis Park MN 55426-4702. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is his primary health care specialty. Waggonner, David Bryan can be contacted via phone (952) 993-3282.

Contact Information

Primary practice address
6500 Excelsior Blvd Saint Louis Park MN 55426-4702
Phone: (952) 993-3282
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X 56763 Minnesota

Profile Details

NPI number 1164600342
LBN Legal business name Waggonner, David Bryan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2008
Last updated Dec 28th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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