Individual
DR. STEPHEN P WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000
(262) 763-7002
Mailing address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-2000
(262) 763-7002
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036145288
IL
207W00000X
Ophthalmology Physician
Primary
41625
WI
207W00000X
Ophthalmology Physician
41625020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34215000
—
WI
01
—
OI023258048
NEW YORK
NY
Enumeration date
08/31/2006
Last updated
05/02/2025
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