Individual
PETER WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 HERITAGE WAY, SUITE 1100, KALISPELL, MT 59901-3158
(406) 752-8900
(406) 752-8909
Mailing address
350 HERITAGE WAY, SUITE 1100, KALISPELL, MT 59901-3158
(406) 752-8900
(406) 752-8909
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
12637
MT
207RH0003X
Hematology & Oncology Physician
PENDING
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04208790
—
CO
Enumeration date
05/23/2007
Last updated
11/27/2023
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