Wagner, Robert Clark
Wagner, Robert Clark is an sole proprietor health care provider with primary practice located at 1635 N George Mason Dr Suite 140, Arlington VA 22205-3601. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Wagner, Robert Clark can be contacted via phone (703) 243-7677.Contact Information
Primary practice address
1635 N George Mason Dr Suite 140
Arlington VA 22205-3601
Phone: (703) 243-7677
Fax: (703) 243-5416
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 0101030296 | Virginia |
Profile Details
| NPI number | 1972568293 |
|---|---|
| LBN Legal business name | Wagner, Robert Clark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Oct 27th, 2011 - about 14 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 | 1972568293 | NPPES |
| Virginia | MEDICAID | 7393202 |
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