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Individual

THANH H DUONG WAGNER

Active
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Individual

THANH H DUONG WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
22999
WI
207RC0000X
Cardiovascular Disease Physician
Primary
ME77423
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009926650
AL
05
2594315 00
FL
Enumeration date
07/26/2005
Last updated
09/14/2022
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