John E Wagner
Pediatrician Pediatric Hematology-Oncologist
516 Delaware St Se Pwb Fifth Floor, Suite 5-100, Clinic 5b
Minneapolis
, Minnesota 55455-0356
John E Wagner
Pediatrician Pediatric Hematology-Oncologist
516 Delaware St Se Pwb Fifth Floor, Suite 5-100, Clinic 5b
Minneapolis
, Minnesota 55455-0356
(612) 626-2663
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About
Features
Specialties
- Pediatrician
- Pediatric Hematology-Oncologist
Languages spoken
- English
Location
First Address
- John E Wagner
- 420 Delaware St Se Mmc 692,University Of Minnesota Physicians
- Minneapolis, MN
- Zip : 55455-0341
- Phone : (612) 626-2663
Second Address
- John E Wagner
- 516 Delaware St Se Pwb Fifth Floor, Suite 5-100, Clinic 5b
- Minneapolis, MN
- Zip : 55455-0356
- Phone : (612) 626-2663
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208000000X | Pediatrician | 34354 | MN |
| Y | 2080P0207X | Pediatric Hematology-Oncologist | 34354 | MN |
National Provider Identifier
| NPI | 1205933595 |
|---|---|
| Provider Name | John E Wagner |
| First Address | Minneapolis, MN 55455-0341 |
| Second Address | Minneapolis, MN 55455-0356 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/09/2006 |
| Last Update Date | 29/10/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 090290 | FAIRVIEW (01) | MN |
| 1009344 | PREFERREDONE (01) | MN |
| 100981 | UCARE (01) | MN |
| 10387 | (05) | ND |
| 1688300 | (05) | WI |
| 1896241 | (05) | LA |
| 1970657 | (05) | IA |
| 2086719201 | (05) | KS |
| 2T332WA | BLUE CROSS BLUE SHIELD (01) | MN |
| 3624608 | MEDICA - CHOICE (01) | MN |
| 3674548 | MEDICA - PRIMARY (01) | MN |
| 768393 | ARAZ (01) | MN |
| 7777470 | (05) | SD |
| 837207100 | (05) | MN |
| HP22006 | HEALTHPARTNERS (01) | MN |
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.