Individual
LUKE WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 SPRUCE ST, PHILADELPHIA, PA 19106-4022
(215) 829-3358
(215) 829-3438
Mailing address
3400 SPRUCE ST, GRD RAVDIN, PHILADELPHIA, PA 19104-4206
(215) 829-3358
(215) 829-3438
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD471951
PA
Other
Enumeration date
05/02/2018
Last updated
09/22/2025
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