Individual
DR. MATTHEW ROY WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2001 N CHURCH ST STE 101, GREENSBORO, NC 27405-5633
(336) 375-6990
Mailing address
2001 N CHURCH ST, GREENSBORO, NC 27405-5633
(336) 375-6990
(336) 375-0361
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
612
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
SC006317
PA
Other
Enumeration date
07/08/2011
Last updated
03/11/2024
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