Individual
MR. WILLIAM WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1710 CHEYENNE DR, HILLSBOROUGH, NC 27278-9500
(919) 619-4998
Mailing address
1710 CHEYENNE DR, HILLSBOROUGH, NC 27278-9500
(919) 619-4998
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
109814
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050655
—
NC
Enumeration date
07/26/2006
Last updated
02/17/2011
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