Wagstaff, Daniel Lee
Wagstaff, Daniel Lee is an individual health care provider with primary practice located at 101 E Wood St , Spartanburg SC 29303-3040. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wagstaff, Daniel Lee can be contacted via phone (864) 560-6654.Contact Information
Primary practice address
101 E Wood St
Spartanburg SC 29303-3040
Phone: (864) 560-6654
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 24395 | South Carolina |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 203440 | Louisiana |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 203440 | Louisiana |
Profile Details
| NPI number | 1417904442 |
|---|---|
| LBN Legal business name | Wagstaff, Daniel Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2006 |
| Last updated | Feb 12th, 2016 - about 8 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 | 1417904442 | NPPES |
| South Carolina | Other | 576007863071 | BLUECHOICE HEALTHPLAN ID |
| South Carolina | Other | 576007863095 | BLUECHOICE HEALTHPLAN ID |
| South Carolina | MEDICAID | 1808580 | BLUECHOICE HEALTHPLAN ID |
| South Carolina | Other | P00110891 | BLUECHOICE HEALTHPLAN ID |
| South Carolina | Other | 5135341 | BLUECHOICE HEALTHPLAN ID |
| South Carolina | MEDICAID | 243953 | BLUECHOICE HEALTHPLAN ID |
| South Carolina | MEDICAID | 03427237 | BLUECHOICE HEALTHPLAN ID |
| South Carolina | Other | 7712588 | BLUECHOICE HEALTHPLAN ID |
| South Carolina | Other | P01577390 | BLUECHOICE HEALTHPLAN ID |
Popular Providers
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Clary, Jeffrey
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