Individual
MATTHEW ANTHONY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2544
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 803-5759
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2020-04816
NC
Other
Enumeration date
03/26/2018
Last updated
08/26/2025
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