Individual
KRAIG M WANGSNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1348 WALTON WAY, SUITE 5100, AUGUSTA, GA 30901-5104
(706) 724-8611
(706) 724-6202
Mailing address
1348 WALTON WAY, SUITE 5100, AUGUSTA, GA 30901-5104
(706) 724-8611
(706) 724-6202
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
039003
GA
207RI0011X
Interventional Cardiology Physician
Primary
39003
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00624665B
—
GA
01
—
273305
BCBS
GA
01
—
2984464-003
CIGNA
GA
01
—
4539908
AETNA PPO
—
05
—
G39003
—
SC
Enumeration date
07/17/2006
Last updated
12/27/2023
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