Individual
MARK STEPHEN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
298 MEMORIAL DR, SENECA, SC 29672-9443
(864) 885-7758
(864) 885-7749
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6306
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
31391
SC
208M00000X
Hospitalist Physician
Primary
31391
SC
Other
Enumeration date
02/08/2006
Last updated
05/20/2019
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