Individual
DR. ROBERT JOSEPH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
(651) 291-2848
Mailing address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
(651) 291-2848
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29811
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-21095
MEDICA
MN
01
—
108722
UCARE
MN
05
—
527792200
—
MN
01
—
554K3WA
BCBS
MN
01
—
HP11665
HEALTH PARTNERS
MN
01
—
NA9020420008
PREFERRED ONE
MN
Enumeration date
03/27/2006
Last updated
09/10/2008
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