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Individual

ERIC R WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
59 EXECUTIVE PARK S STE 2000, ATLANTA, GA 30329-2208
(404) 778-7249
Mailing address
59 EXECUTIVE PARK S STE 2000, ATLANTA, GA 30329-2208
(404) 778-7249

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
269905
MA
207X00000X
Orthopaedic Surgery Physician
55500
MN
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
081317
GA

Other

Enumeration date
06/22/2011
Last updated
10/04/2018
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