Wagner, Christian T

Wagner, Christian T is an individual health care provider with primary practice located at 135 Gold Star Blvd , Worcester MA 01606. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Wagner, Christian T can be contacted via phone (508) 853-2716.

Contact Information

Primary practice address
135 Gold Star Blvd Worcester MA 01606
Phone: (508) 853-2716
Fax: (508) 856-9025
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 202641 Massachusetts

Profile Details

NPI number 1053372987
LBN Legal business name Wagner, Christian T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2006
Last updated Jul 8th, 2007 - about 17 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 1053372987 NPPES
Other 3204235 MEDICAID WELFARE
Other 44949 MEDICAID WELFARE
Other 784219 MEDICAID WELFARE
Other A30514 MEDICAID WELFARE
Other 7370306 MEDICAID WELFARE
Other 3204235 MEDICAID WELFARE
MEDICAID 3204235 MEDICAID WELFARE
Other 7200046 MEDICAID WELFARE
Other AA5533 MEDICAID WELFARE
Other J21993 MEDICAID WELFARE
Other 1818742 MEDICAID WELFARE
Other J21993 MEDICAID WELFARE
Other J21993 MEDICAID WELFARE

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