Stephen Faust Wagner
Pediatrician Clinical Genetics (M.D.)
714 S Birch Ave
Marshfield
, Wisconsin 54449-3326
Stephen Faust Wagner
Pediatrician Clinical Genetics (M.D.)
714 S Birch Ave
Marshfield
, Wisconsin 54449-3326
(715) 486-9539
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About
Features
Specialties
- Clinical Genetics (M.D.)
- Pediatrician
Languages spoken
- English
Location
First Address
- Stephen Faust Wagner
- 714 S Birch Ave
- Marshfield, WI
- Zip : 54449-3326
- Phone : (715) 486-9539
Second Address
- Stephen Faust Wagner
- 714 S Birch Ave
- Marshfield, WI
- Zip : 54449-3326
- Phone : (715) 486-9539
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207SG0201X | Clinical Genetics (M.D.) | 15689 | WI |
| N | 208000000X | Pediatrician | 15689 | WI |
National Provider Identifier
| NPI | 1154583805 |
|---|---|
| Provider Name | Stephen Faust Wagner |
| First Address | Marshfield, WI 54449-3326 |
| Second Address | Marshfield, WI 54449-3326 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/06/2008 |
| Last Update Date | 25/06/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| AW2842234 | DEA (01) |
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.