Individual
RICK JOSEPH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 E 8TH ST STE 202, WINNER, SD 57580-2633
(605) 842-1612
(605) 842-3837
Mailing address
825 E 8TH ST STE 202, WINNER, SD 57580-2633
(605) 842-1612
(605) 842-3837
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4183
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25420
SANFORD HEALTH PLAN
SD
01
—
41831
DAKOTACARE
SD
05
—
460381151-13
—
NE
01
—
4992949
WELLMARK BC/BS
SD
05
—
7301542
—
SD
Enumeration date
04/25/2006
Last updated
12/13/2016
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