Individual
BENJAMIN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
333 BORTHWICK AVE, PORTSMOUTH, NH 03801-7128
(603) 570-3118
Mailing address
333 BORTHWICK AVE STE 100, PORTSMOUTH, NH 03801-4198
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
24500
NH
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
11/04/2024
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