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JEFFREY M WAGNER MD

Allergy and Immunology

Spartanburg, South Carolina

Provider NPI: 1881684207

Provider Information:
 JEFFREY M WAGNER MD


Practice Location:
98 WILLOW LN  SPARTANBURG, SC 29307 US
Tel: 864-585-5552  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207K00000XPhysicians
Allergy & Immunology
SC16033
N207K00000XPhysicians
Allergy & Immunology
NC35781

Other Provider Identifiers:

IssuerNumberStateType
MEDICARE PTANE593334292SC01
160337SC05
AETNA6554SC01
MEDCOST56220SC01
MEDICARE PTAN2174958BNC01
AMERIGROUP1068814SC01
8985201NC05
BCBS85201NC01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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