Wagner, Stephen P

Wagner, Stephen P is an individual health care provider with primary practice located at 515 22Nd Ave , Monroe WI 53566-1569. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Wagner, Stephen P can be contacted via phone (608) 324-2000.

Contact Information

Primary practice address
515 22Nd Ave Monroe WI 53566-1569
Phone: (608) 324-2000
Fax: (262) 763-7002
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 41625020 Wisconsin
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 41625 Wisconsin

Profile Details

NPI number 1255443412
LBN Legal business name Wagner, Stephen P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Dec 29th, 2020 - about 6 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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Identifiers

StateTypeNumberIssuer
All States NPI 1255443412 NPPES
Wisconsin MEDICAID 34215000
Wisconsin Other OI023258048

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