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Individual

DR. DAVID V WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2730 PIERCE ST, SUITE 204, SIOUX CITY, IA 51104-3796
(712) 234-8787
(712) 234-8777
Mailing address
2730 PIERCE ST, SUITE 204, SIOUX CITY, IA 51104-3796
(712) 234-8787
(712) 234-8777

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
29266
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025458200
NE
01
1799
MIDLANDS CHOICE
01
28672
WELLMARK BCBS OF IOWA
IA
05
3111864
IA
05
7771514
SD
01
P00365203
MEDICARE RAILROAD
IA
Enumeration date
01/25/2006
Last updated
04/28/2008
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