Wagner, Ida Janelle
Wagner, Ida Janelle is an individual health care provider with primary practice located at 3509 N Broad St , Philadelphia PA 19140-4105. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Wagner, Ida Janelle can be contacted via phone (215) 707-3933.Contact Information
Primary practice address
3509 N Broad St
Philadelphia PA 19140-4105
Phone: (215) 707-3933
Fax: (215) 707-2531
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD434346 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 25MA11470600 | New Jersey |
Profile Details
| NPI number | 1689839177 |
|---|---|
| LBN Legal business name | Wagner, Ida Janelle |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 23rd, 2008 |
| Last updated | Aug 24th, 2022 - 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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