Individual
GEORGE G WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5400 KENNEDY AVE, CINCINNATI, OH 45213-2664
(513) 281-3400
Mailing address
5400 KENNEDY AVE, CINCINNATI, OH 45213-2664
(513) 281-3400
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
35054831
OH
2085R0202X
Diagnostic Radiology Physician
Primary
35054831
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0816406
—
OH
05
—
64865140
—
KY
Enumeration date
05/30/2006
Last updated
08/08/2016
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