Wagner, Bradford S.
Wagner, Bradford S. is an individual health care provider with primary practice located at 50 Foden Rd Ste 3 , South Portland ME 04106-1718. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Wagner, Bradford S. can be contacted via phone (207) 874-1489.Contact Information
Primary practice address
50 Foden Rd Ste 3
South Portland ME 04106-1718
Phone: (207) 874-1489
Fax: (207) 523-8590
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD19486 | Maine |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | MD19486 | Maine |
Profile Details
| NPI number | 1083848030 |
|---|---|
| LBN Legal business name | Wagner, Bradford S. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 6th, 2009 |
| Last updated | Feb 14th, 2024 - about 9 months 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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