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
Fax: (920) 968-1794
Website:

Health care specialties

SpecialtyCodeLicense #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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