Individual
DR. MARTIN HENRY WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5651 FRIST BLVD, SUITE 413, HERMITAGE, TN 37076-2054
(615) 885-0110
(615) 885-8110
Mailing address
5651 FRIST BLVD, SUITE 413, HERMITAGE, TN 37076-2054
(615) 885-0110
(615) 885-8110
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
15706
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3009875
—
TN
Enumeration date
08/14/2006
Last updated
11/23/2009
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