Individual
DR. CLIFF W WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2909 BERLIN TPKE, NEWINGTON, CT 06111-4115
(860) 436-3757
(860) 436-9622
Mailing address
2909 BERLIN TPKE, NEWINGTON, CT 06111-4115
(860) 436-3757
(860) 436-9622
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
030264
CT
207Q00000X
Family Medicine Physician
Primary
030264
CT
Other
Enumeration date
04/02/2007
Last updated
05/15/2014
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