Individual
DR. ROBERT D WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1690 LAYTON RD, FREELAND, WA 98249-9456
(360) 331-1314
(360) 331-9703
Mailing address
275 SE CABOT DR STE B102, OAK HARBOR, WA 98277-3740
(360) 675-5555
(360) 675-0275
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00020537
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1070135
—
WA
Enumeration date
06/27/2006
Last updated
05/29/2019
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