Wagner, Jeffrey M

Wagner, Jeffrey M is an individual health care provider with primary practice located at 98 Willow Ln , Spartanburg SC 29307-1357. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Wagner, Jeffrey M can be contacted via phone (864) 585-5552.

Contact Information

Primary practice address
98 Willow Ln Spartanburg SC 29307-1357
Fax: (864) 597-0179
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 16033 South Carolina
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X MD16033 South Carolina
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 35781 North Carolina

Profile Details

NPI number 1881684207
LBN Legal business name Wagner, Jeffrey M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Oct 31st, 2023 - about 2 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 1881684207 NPPES
North Carolina MEDICAID 1235321233
North Carolina Other E593334292
North Carolina MEDICAID 160337
North Carolina Other 2174958B

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