Individual
SEAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3949 BROWNING PL, RALEIGH, NC 27609-6536
(919) 787-7411
Mailing address
3949 BROWNING PL, RALEIGH, NC 27609-6536
(919) 787-7411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT214524
PA
2085B0100X
Body Imaging Physician
Primary
2019-02277
NC
Other
Enumeration date
06/23/2017
Last updated
02/15/2023
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