James M Wagner
Chiropractic Sports Physician
107 Ridgely Ave Ste. 11
Annapolis
, Maryland 21401-1417
James M Wagner
Chiropractic Sports Physician
107 Ridgely Ave Ste. 11
Annapolis
, Maryland 21401-1417
(410) 267-0667
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About
Features
Specialties
- Chiropractic Sports Physician
Languages spoken
- English
Location
First Address
- James M Wagner
- 107 Ridgely Ave Ste. 11
- Annapolis, MD
- Zip : 21401-1417
- Fax : (410) 267-0667
- Phone : (410) 267-0033
Second Address
- James M Wagner
- 107 Ridgely Ave Ste. 11
- Annapolis, MD
- Zip : 21401-1417
- Fax : (410) 267-0667
- Phone : (410) 267-0033
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NS0005X | Chiropractic Sports Physician | 1457/PT | MD |
National Provider Identifier
| NPI | 1083791818 |
|---|---|
| Provider Name | James M Wagner |
| First Address | Annapolis, MD 21401-1417 |
| Second Address | Annapolis, MD 21401-1417 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/11/2006 |
| Last Update Date | 08/01/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| M155 | BCBS (01) | MD |
| U61465 | (02) | MD |
| W2090001 | BCBS FEP (01) | MD |
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.