Dr. Corey Allen Wagner
Obstetrician & Gynecologist Gynecologist
621 S New Ballas Rd Suite 499-A
Saint Louis
, Missouri 63141-8232
Dr. Corey Allen Wagner
Obstetrician & Gynecologist Gynecologist
621 S New Ballas Rd Suite 499-A
Saint Louis
, Missouri 63141-8232
(314) 251-7650
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About
Features
Specialties
- Obstetrician & Gynecologist
- Gynecologist
Languages spoken
- English
Location
First Address
- Dr. Corey Allen Wagner
- 621 S New Ballas Rd Suite 499-A
- Saint Louis, MO
- Zip : 63141-8232
- Phone : (314) 251-7650
Second Address
- Dr. Corey Allen Wagner
- 621 S New Ballas Rd Suite 499-A
- Saint Louis, MO
- Zip : 63141-8232
- Phone : (314) 251-7650
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207V00000X | Obstetrician & Gynecologist | 2010020901 | MO |
| N | 207V00000X | Obstetrician & Gynecologist | 259975-1 | NY |
| Y | 207VG0400X | Gynecologist | 2010020901 | MO |
National Provider Identifier
| NPI | 1144428038 |
|---|---|
| Provider Name | Dr. Corey Allen Wagner |
| First Address | Saint Louis, MO 63141-8232 |
| Second Address | Saint Louis, MO 63141-8232 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/07/2007 |
| Last Update Date | 18/06/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1144428038 | (05) | MO |
| P01364351 | RAILROAD MEDICARE (01) | MO |
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.