Wagstaff, Donna M
Wagstaff, Donna M is an individual health care provider with primary practice located at 4438 Telegraph Rd , Saint Louis MO 63129-3316. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wagstaff, Donna M can be contacted via phone (314) 543-5996.Contact Information
Primary practice address
4438 Telegraph Rd
Saint Louis MO 63129-3316
Phone: (314) 543-5996
Fax: (314) 543-5958
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 120005 | Missouri |
Profile Details
| NPI number | 1326030586 |
|---|---|
| LBN Legal business name | Wagstaff, Donna M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2005 |
| Last updated | Apr 9th, 2019 - about 7 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 | 1326030586 | NPPES |
| Missouri | Other | 156880001 | MEDICARE PTAN # |
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