Individual
DR. DANIEL GRAY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
224 S WOODS MILL RD, SUITE 750, CHESTERFIELD, MO 63017-3451
(314) 576-9797
(314) 469-7517
Mailing address
224 S WOODS MILL RD, SUITE 750, CHESTERFIELD, MO 63017-3451
(314) 576-9797
(314) 469-7517
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
103423
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206878605
—
MO
Enumeration date
10/03/2006
Last updated
04/21/2020
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