Individual
DR. STEVEN J. WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
102 RIVERVIEW DR STE A, FLOWOOD, MS 39232-8908
(601) 981-1610
(601) 366-2887
Mailing address
102 RIVERVIEW DR STE A, FLOWOOD, MS 39232-8908
(601) 981-1610
(601) 366-2887
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
22240
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07376214
—
MS
Enumeration date
01/31/2006
Last updated
10/10/2019
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