Individual
JOSEPH ROBERT WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
85 SEYMOUR ST, STE 416, HARTFORD, CT 06106-5501
(860) 947-8500
(860) 524-8643
Mailing address
85 SEYMOUR ST, STE 416, HARTFORD, CT 06106-5501
(860) 947-8500
(860) 524-8643
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
041512
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001415125
—
CT
01
—
010041512CT01
ANTHEM BCBS
CT
05
—
2020611
—
MA
01
—
227400
WELLCARE
CT
01
—
2V3291
HEALTH NET
CT
01
—
3231961
AETNA
CT
01
—
32475
HEALTH NEW ENGLAND
CT
01
—
3528766 009
CIGNA
CT
01
—
P2913141
OXFORD
CT
Enumeration date
10/04/2005
Last updated
02/05/2016
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