Wagner, Kristin Elizabeth

Wagner, Kristin Elizabeth is an individual health care provider with primary practice located at 1918 Randolph Rd Ste 300 , Charlotte NC 28207-1112. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Wagner, Kristin Elizabeth can be contacted via phone (704) 333-0741.

Contact Information

Primary practice address
1918 Randolph Rd Ste 300 Charlotte NC 28207-1112
Phone: (704) 333-0741
Fax: (704) 333-3356
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 200301072 North Carolina

Profile Details

NPI number 1518943166
LBN Legal business name Wagner, Kristin Elizabeth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Nov 5th, 2025 - about last year

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 1518943166 NPPES
North Carolina MEDICAID 891345G

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