Wagner, Jeffrey M
Wagner, Jeffrey M is an individual health care provider with primary practice located at 98 Willow Ln , Spartanburg SC 29307-1357. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Wagner, Jeffrey M can be contacted via phone (864) 585-5552.Contact Information
Primary practice address
98 Willow Ln
Spartanburg SC 29307-1357
Phone: (864) 585-5552
Fax: (864) 597-0179
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 16033 | South Carolina |
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | MD16033 | South Carolina |
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 35781 | North Carolina |
Profile Details
| NPI number | 1881684207 |
|---|---|
| LBN Legal business name | Wagner, Jeffrey M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2005 |
| Last updated | Oct 31st, 2023 - about 3 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 | 1881684207 | NPPES |
| North Carolina | MEDICAID | 1235321233 | |
| North Carolina | Other | E593334292 | |
| North Carolina | MEDICAID | 160337 | |
| North Carolina | Other | 2174958B |
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