Wagner, John E
Wagner, John E is an individual health care provider with primary practice located at 516 Delaware St Se Pwb Fifth Floor, Suite 5-100, Clinic 5B, Minneapolis MN 55455-0356. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology. Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology is his primary health care specialty. Wagner, John E can be contacted via phone (612) 626-2663.Contact Information
Primary practice address
516 Delaware St Se Pwb Fifth Floor, Suite 5-100, Clinic 5B
Minneapolis MN 55455-0356
Phone: (612) 626-2663
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 34354 | Minnesota |
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 34354 | Minnesota |
Profile Details
| NPI number | 1205933595 |
|---|---|
| LBN Legal business name | Wagner, John E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Oct 29th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205933595 | NPPES |
| Minnesota | Other | 090290 | FAIRVIEW |
| Minnesota | Other | 100981 | FAIRVIEW |
| Minnesota | MEDICAID | 837207100 | FAIRVIEW |
| Minnesota | MEDICAID | 1896241 | FAIRVIEW |
| Minnesota | Other | 2T332WA | FAIRVIEW |
| Minnesota | MEDICAID | 1970657 | FAIRVIEW |
| Minnesota | MEDICAID | 2086719201 | FAIRVIEW |
| Minnesota | MEDICAID | 10387 | FAIRVIEW |
| Minnesota | MEDICAID | 1688300 | FAIRVIEW |
| Minnesota | Other | 3624608 | FAIRVIEW |
| Minnesota | Other | 3674548 | FAIRVIEW |
| Minnesota | Other | HP22006 | FAIRVIEW |
| Minnesota | Other | 1009344 | FAIRVIEW |
| Minnesota | Other | 768393 | FAIRVIEW |
| Minnesota | MEDICAID | 7777470 | FAIRVIEW |
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