Wagner, Debra Ann

Wagner, Debra Ann is an individual health care provider with primary practice located at 727 Se Main St Suite 300, Simpsonville SC 29681-3247. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Wagner, Debra Ann can be contacted via phone (864) 522-1170.

Contact Information

Primary practice address
727 Se Main St Suite 300 Simpsonville SC 29681-3247
Phone: (864) 522-1170
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 200500395 North Carolina
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 32275 South Carolina

Profile Details

NPI number 1013989623
LBN Legal business name Wagner, Debra Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Dec 14th, 2015 - about 9 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 1013989623 NPPES
North Carolina MEDICAID 89139NW
North Carolina MEDICAID 322751

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