Individual
DR. BRIAN KEITH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
000793
CT
213ER0200X
Radiology Podiatrist
000793
CT
213ES0103X
Foot & Ankle Surgery Podiatrist
000862
CT
213ES0131X
Foot Surgery Podiatrist
Primary
000793
CT
Other
Enumeration date
06/30/2006
Last updated
08/20/2020
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