Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 19603 | AZ |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD2011-0010 | NM |
NPI | 1275682429 |
---|---|
Provider Name | Dr. Gael Patricia Wager |
First Address | Albuquerque, NM 87106-4375 |
Second Address | Albuquerque, NM 87106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 31/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
297889 | (05) | AZ |
AW8706484 | DEA (01) | |
D81467 | (02) | AZ |