Individual
DR. JULIE A WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14A MOUNT CARMEL RD, PARKTON, MD 21120-9721
(410) 357-9283
Mailing address
PO BOX 631568, BALTIMORE, MD 21263-1568
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D63852
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
409650900
—
MD
Enumeration date
06/12/2006
Last updated
06/24/2008
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