Dr. Charles I Wagner
Gastroenterologist
1095 Rydal Rd Suite 100
Rydal
, Pennsylvania 19046-1711
Dr. Charles I Wagner
Gastroenterologist
1095 Rydal Rd Suite 100
Rydal
, Pennsylvania 19046-1711
(215) 572-1279
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About
Features
Specialties
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Dr. Charles I Wagner
- 1095 Rydal Rd Suite 100
- Rydal, PA
- Zip : 19046-1711
- Fax : (215) 572-1279
- Phone : (267) 620-1100
Second Address
- Dr. Charles I Wagner
- 1095 Rydal Rd Suite 100
- Rydal, PA
- Zip : 19046-1711
- Fax : (215) 572-1279
- Phone : (267) 620-1100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0100X | Gastroenterologist | MD010259E | PW |
National Provider Identifier
| NPI | 1053353920 |
|---|---|
| Provider Name | Dr. Charles I Wagner |
| First Address | Rydal, PA 19046-1711 |
| Second Address | Rydal, PA 19046-1711 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/06/2006 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0046041000 | KEYSTONE EAST (01) | PA |
| 007542510002 | (05) | PW |
| 0949753 | CIGNA (01) | PA |
| 14617 | HEALTH PARTNERS (01) | PW |
| P406157 | OXFORD (01) | PA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.