Individual
ERIC LEE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 MARKET ST FL 2, PHILADELPHIA, PA 19104-3317
(215) 746-7222
Mailing address
7336 S PIERCE CT, LITTLETON, CO 80128-4517
(719) 661-7290
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/23/2022
Last updated
03/23/2022
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