Wagner, Christian T
Wagner, Christian T is an individual health care provider with primary practice located at 135 Gold Star Blvd , Worcester MA 01606. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Wagner, Christian T can be contacted via phone (508) 853-2716.Contact Information
Primary practice address
135 Gold Star Blvd
Worcester MA 01606
Phone: (508) 853-2716
Fax: (508) 856-9025
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 202641 | Massachusetts |
Profile Details
| NPI number | 1053372987 |
|---|---|
| LBN Legal business name | Wagner, Christian T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1053372987 | NPPES |
| Other | 3204235 | MEDICAID WELFARE | |
| Other | 44949 | MEDICAID WELFARE | |
| Other | 784219 | MEDICAID WELFARE | |
| Other | A30514 | MEDICAID WELFARE | |
| Other | 7370306 | MEDICAID WELFARE | |
| Other | 3204235 | MEDICAID WELFARE | |
| MEDICAID | 3204235 | MEDICAID WELFARE | |
| Other | 7200046 | MEDICAID WELFARE | |
| Other | AA5533 | MEDICAID WELFARE | |
| Other | J21993 | MEDICAID WELFARE | |
| Other | 1818742 | MEDICAID WELFARE | |
| Other | J21993 | MEDICAID WELFARE | |
| Other | J21993 | MEDICAID WELFARE |
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