Wagner, Edward Steven

Wagner, Edward Steven is an sole proprietor health care provider with primary practice located at 4330 Sheridan St Ste 101, Hollywood FL 33021. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Wagner, Edward Steven can be contacted via phone (954) 962-9802.

Contact Information

Primary practice address
4330 Sheridan St Ste 101 Hollywood FL 33021
Fax: (954) 962-2233
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X ME68203 Florida

Profile Details

NPI number 1568435741
LBN Legal business name Wagner, Edward Steven
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 9th, 2006
Last updated Apr 19th, 2011 - about 14 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 1568435741 NPPES
Florida MEDICAID 379684100

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