Individual
DR. RYAN SCOTT WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
140 HILL ST, SUITE B, BUCYRUS, OH 44820-1566
(419) 562-5281
Mailing address
140 HILL ST, SUITE B, BUCYRUS, OH 44820-1566
(419) 562-5281
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
35.096738
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2263161
—
OH
Enumeration date
10/24/2008
Last updated
01/08/2021
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