Individual
DR. GREGORY P. WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 HOSPITAL DR, DEPARTMENT OF EMERGENCY MEDICINE, WARRENTON, VA 20186
(540) 316-4900
Mailing address
10121 CARLINGTON VALLEY CT, MANASSAS, VA 20111-2544
(707) 241-5155
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101246400
VA
207P00000X
Emergency Medicine Physician
A096347
CA
Other
Enumeration date
06/14/2006
Last updated
01/13/2011
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