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Individual
DR. JAIME STEPHAN WAGNER
Active
Individual
DR. JAIME STEPHAN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
162768
OR
2085R0202X
Diagnostic Radiology Physician
2012-00139
NC
2085R0204X
Vascular & Interventional Radiology Physician
Primary
2012-00139
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
01/03/2008
Last updated
03/10/2023
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