Wagner, Elaine Dudley

Wagner, Elaine Dudley is an individual health care provider with primary practice located at 6116 E Warren Ave , Denver CO 80222-5703. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cytopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is her primary health care specialty. Wagner, Elaine Dudley can be contacted via phone (303) 512-0888.

Contact Information

Primary practice address
6116 E Warren Ave Denver CO 80222-5703
Phone: (303) 512-0888
Fax: (305) 512-2288
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cytopathology 207ZC0500X 28869 Colorado
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 28869 Colorado

Profile Details

NPI number 1306815170
LBN Legal business name Wagner, Elaine Dudley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2006
Last updated Mar 18th, 2014 - about 12 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 1306815170 NPPES
Colorado MEDICAID 01288695
Colorado MEDICAID 641599
Colorado MEDICAID 50637223

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