Individual
MAXWELL SOLOMON WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 FAIRFAX AVE STE 610, NORFOLK, VA 23507-1914
(757) 446-8950
Mailing address
720 REDGATE AVE APT 6, NORFOLK, VA 23507-1629
(757) 679-8303
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
VA
Other
Enumeration date
03/27/2020
Last updated
03/27/2020
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