Wagner, Alan Lewis

Wagner, Alan Lewis is an individual health care provider with primary practice located at 6160 Kempsville Cir Ste 120B , Norfolk VA 23502-3933. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Retina Specialist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Wagner, Alan Lewis can be contacted via phone (757) 481-4400.

Contact Information

Primary practice address
6160 Kempsville Cir Ste 120B Norfolk VA 23502-3933
Phone: (757) 481-4400
Fax: (757) 481-1285
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 0101039260 Virginia
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 0101039260 Virginia

Profile Details

NPI number 1295719631
LBN Legal business name Wagner, Alan Lewis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Aug 13th, 2019 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1295719631 NPPES
Virginia MEDICAID 006396097
Virginia Other 27210
Virginia Other 202826
Virginia Other 044061

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