Individual
DR. MARGARET A WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2001 S WOODRUFF AVE, SUITE #15, IDAHO FALLS, ID 83404-6374
(208) 522-7310
(208) 524-0559
Mailing address
2001 S WOODRUFF AVE, SUITE #15, IDAHO FALLS, ID 83404-6374
(208) 522-7310
(208) 524-0559
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M4284
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010003953
REGENCE BLUE SHIELD
ID
01
—
4284-6
BLUE CROSS
ID
01
—
MD2942
IDAHO STATE NARC. #
ID
Enumeration date
06/28/2006
Last updated
03/07/2023
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