Individual
HENRY WAGNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033
(717) 531-8024
(717) 531-0882
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD422974
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008285630001
—
PA
Enumeration date
05/22/2006
Last updated
05/15/2018
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