Individual
ALAN LEWIS WAGNER
Active
Individual
ALAN LEWIS WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101039260
VA
207WX0107X
Retina Specialist (Ophthalmology) Physician
0101039260
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006396097
—
VA
01
—
044061
ANTHEM
VA
01
—
202826
CIGNA
VA
01
—
27210
OPTIMA
VA
Enumeration date
11/30/2005
Last updated
08/13/2019
Update your record
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