Individual
MICHAEL GEOFFREY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
(475) 210-5718
Mailing address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
(475) 210-5718
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
74026
CT
Other
Enumeration date
05/08/2020
Last updated
07/07/2023
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