Wagner, Theodore A

Wagner, Theodore A is an individual health care provider with primary practice located at Uwmc-Roosevelt 4245 Roosevelt Way Ne, Seattle WA 98105-4740. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine is his primary health care specialty. Wagner, Theodore A can be contacted via phone (206) 598-4288.

Contact Information

Primary practice address
Uwmc-Roosevelt 4245 Roosevelt Way Ne Seattle WA 98105-4740
Phone: (206) 598-4288
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X MD00011315 Washington
Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery 207XP3100X MD00011315 Washington
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X MD00011315 Washington

Profile Details

NPI number 1811077894
LBN Legal business name Wagner, Theodore A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Sep 28th, 2011 - about 15 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 1811077894 NPPES
Washington Other 0232121 L&I
Washington Other 9054 L&I
Washington MEDICAID 1811077894 L&I

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