Individual
HEATHER WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
423 RIDGEWOOD DR, POINT PLEASANT, WV 25550-3583
(304) 593-0188
Mailing address
423 RIDGEWOOD DR, POINT PLEASANT, WV 25550-3583
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2020-03176
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2017
Last updated
08/12/2020
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