Individual
KRISTINA MARIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1220
Mailing address
3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC HEMATOLOGY - ONCOLOGY, PHILADELPHIA, PA 19104
(267) 426-3574
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MT220117
PA
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
MT220117
PA
Other
Enumeration date
05/16/2020
Last updated
06/19/2024
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