Wagner, Robert Harrison

Wagner, Robert Harrison is an individual health care provider with primary practice located at 8501 Arlington Blvd Ste 410 , Fairfax VA 22031. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Wagner, Robert Harrison can be contacted via phone (703) 738-4331.

Contact Information

Primary practice address
8501 Arlington Blvd Ste 410 Fairfax VA 22031
Phone: (703) 738-4331
Fax: (703) 642-1876
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 0101054689 Virginia
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 0101054689 Virginia

Profile Details

NPI number 1457329997
LBN Legal business name Wagner, Robert Harrison
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2006
Last updated Jul 26th, 2021 - about 3 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 1457329997 NPPES
Virginia MEDICAID 6801765

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