Individual
ROBERT WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3800 RESERVOIR RD NW # 2PHC, WASHINGTON, DC 20007-2113
(954) 262-1250
Mailing address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-1250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA200001305
DC
Other
Enumeration date
01/04/2020
Last updated
04/27/2022
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