Individual
MATTHEW JAMES WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17213 COLE RD, HAGERSTOWN, MD 21740-6981
(301) 582-9183
Mailing address
17213 COLE RD, HAGERSTOWN, MD 21740-6981
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202216947
VA
183500000X
Pharmacist
25826
MD
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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