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Individual
SCOTT A WAGNER
Active
Individual
SCOTT A WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
1036220
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
1036220
IN
Other
Enumeration date
06/20/2006
Last updated
01/09/2012
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