Individual
JOHN G. WAGNITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 CARBONTON RD, SANFORD, NC 27330-4009
(919) 774-6521
Mailing address
130 CARBONTON RD, SANFORD, NC 27330-4009
(919) 774-6521
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
28588
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7985198
—
NC
Enumeration date
06/30/2006
Last updated
11/24/2020
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