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Individual

DR. STEPHEN R WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 735-0501
(651) 735-1870
Mailing address
8681 EAGLE POINT BLVD, LAKE ELMO, MN 55042-8628
(651) 251-8021
(651) 251-8050

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35533
MN
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
35533
MN
208VP0014X
Interventional Pain Medicine Physician
35533
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
386213500
MN
Enumeration date
08/31/2006
Last updated
11/24/2025
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