Wagner, David Gordon
Wagner, David Gordon is an sole proprietor health care provider with primary practice located at 14955 Shady Grove Rd Suite 125, Rockville MD 20850-8700. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Wagner, David Gordon can be contacted via phone (301) 765-1816.Contact Information
Primary practice address
14955 Shady Grove Rd Suite 125
Rockville MD 20850-8700
Phone: (301) 765-1816
Fax: (301) 838-9712
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | D0051588 | Maryland |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | D0051588 | Maryland |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD20367 | District of Columbia |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 0101053417 | Virginia |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | G64967 | California |
Profile Details
| NPI number | 1326046897 |
|---|---|
| LBN Legal business name | Wagner, David Gordon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 8th, 2005 |
| Last updated | Oct 13th, 2010 - about 14 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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