Wagner, Suzanne

Wagner, Suzanne is an individual health care provider with primary practice located at 1046 E Wendover Ave , Greensboro NC 27405-6712. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wagner, Suzanne can be contacted via phone (336) 272-1050.

Contact Information

Primary practice address
1046 E Wendover Ave Greensboro NC 27405-6712
Fax: (336) 272-1110
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 29970 North Carolina

Profile Details

NPI number 1902801079
LBN Legal business name Wagner, Suzanne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Mar 7th, 2023 - about last year

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 1902801079 NPPES
North Carolina Other 29970 NC LICENSE
North Carolina MEDICAID 7985192 NC LICENSE

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