Individual
DR. DAVID BRYAN WAGGONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6500 EXCELSIOR BLVD, SAINT LOUIS PARK, MN 55426-4702
(952) 993-3282
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
56763
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/10/2008
Last updated
12/28/2022
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