Wagner, Dennis L

Wagner, Dennis L is an individual health care provider with primary practice located at 1120 South Dr # Fh204 , Indianapolis IN 46202-5135. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Wagner, Dennis L can be contacted via phone (317) 944-2891.

Contact Information

Primary practice address
1120 South Dr # Fh204 Indianapolis IN 46202-5135
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 01027891 Indiana
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 01027891A Indiana
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 01027891 Indiana

Profile Details

NPI number 1891750501
LBN Legal business name Wagner, Dennis L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Nov 23rd, 2020 - about 4 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 1891750501 NPPES
Indiana MEDICAID 100324970

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