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Individual
DR. ROBERT JOSEPH WAGNER
Active
Individual
DR. ROBERT JOSEPH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29811
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-21095
MEDICA
MN
01
—
108722
UCARE
MN
05
—
527792200
—
MN
01
—
554K3WA
BCBS
MN
01
—
HP11665
HEALTH PARTNERS
MN
01
—
NA9020420008
PREFERRED ONE
MN
Enumeration date
03/27/2006
Last updated
09/10/2008
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