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Individual
MARK T. WAGNER
Active
Individual
MARK T. WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
34003690W
OH
207Q00000X
Family Medicine Physician
Primary
34.003690
OH
Other
Enumeration date
03/14/2007
Last updated
09/26/2022
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