Individual
DR. CHARLES I WAGNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1095 RYDAL RD, SUITE 100, RYDAL, PA 19046-1711
(267) 620-1100
(215) 572-1279
Mailing address
1095 RYDAL RD, SUITE 100, RYDAL, PA 19046-1711
(267) 620-1100
(215) 572-1279
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD010259E
PW
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046041000
KEYSTONE EAST
PA
05
—
007542510002
—
PW
01
—
0949753
CIGNA
PA
01
—
14617
HEALTH PARTNERS
PW
01
—
P406157
OXFORD
PA
Enumeration date
06/12/2006
Last updated
07/09/2007
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