Individual
DR. ALEXEI WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 724-4100
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
283559
MA
207P00000X
Emergency Medicine Physician
A125137
CA
Other
Enumeration date
07/06/2010
Last updated
02/11/2022
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