Individual
DR. RICHARD GEORGE WAGNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
519 OCEAN BLVD, ISLE OF PALMS, SC 29451-2132
(404) 735-1730
Mailing address
519 OCEAN BLVD, ISLE OF PALMS, SC 29451-2132
(404) 735-1730
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD40355
SC
Other
Enumeration date
07/15/2005
Last updated
03/17/2017
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