Individual
MEREDITH WALL WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4 SMITHFIELD ST FL 11, PITTSBURGH, PA 15222-2222
(412) 224-2336
Mailing address
PO BOX 38567, GERMANTOWN, TN 38183-0567
(760) 472-3064
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036.165930
IL
207N00000X
Dermatology Physician
Primary
58455
TN
207N00000X
Dermatology Physician
A146514
CA
207N00000X
Dermatology Physician
MD.48544
AL
Other
Enumeration date
04/16/2013
Last updated
12/17/2025
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