Individual
MISS JILL M WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
306 WESTWOOD AVE, SUITE 501, HIGH POINT, NC 27262-4341
(336) 802-2536
(336) 802-2534
Mailing address
1701 WESTCHESTER DR, SUITE 850, HIGH POINT, NC 27262-7008
(336) 802-2536
(336) 802-2534
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
9501686
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8911473
—
NC
Enumeration date
01/12/2006
Last updated
12/07/2012
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