Wagner, Russell G
Wagner, Russell G is an individual health care provider with primary practice located at 2160 Fountain Dr Suite D, Snellville GA 30078-7022. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wagner, Russell G can be contacted via phone (770) 982-7790.Contact Information
Primary practice address
2160 Fountain Dr Suite D
Snellville GA 30078-7022
Phone: (770) 982-7790
Fax: (770) 982-7795
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 033740 | Georgia |
Profile Details
| NPI number | 1730168832 |
|---|---|
| LBN Legal business name | Wagner, Russell G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 17th, 2006 |
| Last updated | Dec 23rd, 2013 - about 12 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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