Individual
RYAN MATTHEW WAGENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2601 RIVA RD, ANNAPOLIS, MD 21401-7304
(410) 571-2090
Mailing address
980 SPA RD, APT 203, ANNAPOLIS, MD 21403-1037
(410) 718-7198
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23530
MD
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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