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:
Health care specialties
Specialty | Code | License # | 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 6 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1295719631 | NPPES |
Virginia | MEDICAID | 006396097 | |
Virginia | Other | 27210 | |
Virginia | Other | 202826 | |
Virginia | Other | 044061 |
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