Wagner, Fredrick Charles

Wagner, Fredrick Charles is an individual health care provider with primary practice located at 9205 Sw Barnes Rd , Portland OR 97225-6603. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Wagner, Fredrick Charles can be contacted via phone (503) 216-2195.

Contact Information

Primary practice address
9205 Sw Barnes Rd Portland OR 97225-6603
Phone: (503) 216-2195
Fax: (503) 216-2196
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X MD09972 Oregon

Profile Details

NPI number 1609869635
LBN Legal business name Wagner, Fredrick Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Jul 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609869635 NPPES
Oregon MEDICAID 242487
Oregon MEDICAID 8236705

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