Individual
DR. MATTHEW STEVEN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 E 1ST ST, DULUTH, MN 55805-1901
(218) 786-8364
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
RL15231
ND
2085R0202X
Diagnostic Radiology Physician
Primary
74110
MN
Other
Enumeration date
07/02/2018
Last updated
07/24/2023
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