Organization
LAURA WAGNER, INC
Active
Organization
LAURA WAGNER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA ELLA WAGNER M.D. (PRESIDENT)
(636) 926-8554
Entity
Organization
Contact information
Practice address
6 JUNGERMANN CIR, SUITE 211, SAINT PETERS, MO 63376-1621
(636) 926-7938
(636) 926-2286
Mailing address
PO BOX 790379, SAINT LOUIS, MO 63179-0379
(636) 926-7938
(636) 926-2286
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R8N01
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00004839
MEDICARE PTAN #
MO
01
—
1669445060
TYPE 1 NPI
MO
01
—
18374
BCBSMO PROVIDER#
MO
01
—
211386
HEALTHLINK ID#
MO
01
—
39228V39228
GHP PROVIDER #
MO
01
—
4420124
AETNA PROVIDER #
MO
Enumeration date
08/19/2008
Last updated
08/19/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up