Individual
DR. ARMIN JARED WAGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4350 S NATIONAL AVE, # C-100, SPRINGFIELD, MO 65810-2607
(417) 447-4700
(417) 447-4701
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(800) 243-3839
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
R3P31
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100006210A
—
OK
05
—
150780001
—
AR
05
—
20000020 A
—
KS
05
—
203144100
—
MO
Enumeration date
06/21/2005
Last updated
02/03/2010
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