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Individual
THOR WAGNER
Active
Individual
THOR WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
Primary
MD00044528
WA
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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