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Organization
THE SANGER CLINIC PA
Active
Organization
THE SANGER CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN L. WAGNER PHD (CEO-ADMINISTRATOR)
(704) 373-0212
Entity
Organization
Contact information
Practice address
1001 BLYTHE BLVD STE 300, CHARLOTTE, NC 28203-5863
(704) 373-0212
(704) 373-2626
Mailing address
1001 BLYTHE BLVD STE 300, CHARLOTTE, NC 28203-5863
(704) 373-0212
(704) 373-2626
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
NC
207R00000X
Internal Medicine Physician
—
NC
207RC0000X
Cardiovascular Disease Physician
—
NC
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
NC
207RI0011X
Interventional Cardiology Physician
—
NC
2080P0202X
Pediatric Cardiology Physician
—
NC
2086S0120X
Pediatric Surgery Physician
—
NC
2086S0129X
Vascular Surgery Physician
—
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
NC
363AM0700X
Medical Physician Assistant
—
NC
363AS0400X
Surgical Physician Assistant
—
NC
363LA2100X
Acute Care Nurse Practitioner
—
NC
363LA2200X
Adult Health Nurse Practitioner
—
NC
363LF0000X
Family Nurse Practitioner
—
NC
363LP0200X
Pediatric Nurse Practitioner
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02815
BCBS
NC
05
—
028150
—
SC
05
—
8902815
—
NC
05
—
GP0129
—
SC
Enumeration date
11/24/2006
Last updated
09/11/2025
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