Wagner, Keith Dineen
Wagner, Keith Dineen is an individual health care provider with primary practice located at 3935 N Lightning Dr , Appleton WI 54913-6717. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Wagner, Keith Dineen can be contacted via phone (920) 968-1790.Contact Information
Primary practice address
3935 N Lightning Dr
Appleton WI 54913-6717
Phone: (920) 968-1790
Fax: (920) 968-1794
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 82425-20 | Wisconsin |
Profile Details
| NPI number | 1760047112 |
|---|---|
| LBN Legal business name | Wagner, Keith Dineen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2019 |
| Last updated | Sep 11th, 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.
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