Audrey Susan Wagner in Watertown - Internal Medicine
Audrey Susan Wagner - NPI 1639127152
Audrey Susan Wagner is a Internal Medicine in Watertown, Massachusetts. Audrey Susan Wagner practices all healthcare services and medical treatments related to Internal Medicine. The NPI Number for Audrey Susan Wagner is 1639127152. The last update date is 2011-06-27.
Audrey Susan Wagner's current location address is 485 Arsenal St, Watertown, Massachusetts. You can contact this provider via phone number 6179725200 and fax number 6179725512. The mailing address for Audrey Susan Wagner is 485 Arsenal St, Watertown, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Audrey Susan Wagner |
|---|---|
| Address | 485 Arsenal St, Watertown, Massachusetts |
| Phone Number | 6179725200 |
| Fax Number | 6179725512 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1639127152 |
|---|---|
| Provider Enumeration Date | 2006-05-05 |
| Last Updated Date | 2011-06-27 |
Provider Mailing Address Detail
| Address | 485 Arsenal St |
|---|---|
| City | Watertown |
| State | Massachusetts (MA) |
| Post Code | 24725091 |
| Phone Number | 6179725200 |
| Fax Number | 6179725512 |
Provider's Primary Taxonomy Detail
| Speciality | Internal Medicine |
|---|---|
| Taxonomy | 207R00000X |
| Licence No | 76506 |
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Definition: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and di |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| J17306 | MA | BLUE CROSS | |
| 15296 | MA | NEIGHBORHOOD HEALTH | |
| V467 | MA | HARVARD PILGRIM | |
| 76506 | MA | TUFTS | |
| 3196241 | MA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Audrey Susan Wagner by the Centers for Medicare & Medicaid Services (CMS)?
The Audrey Susan Wagner has been assigned the NPI (National Provider Identifier) 1639127152. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you kindly provide the complete physical address where Audrey Susan Wagner's facilities are geographically located?
The facilities of Audrey Susan Wagner are physically situated at the following location: 485 Arsenal St, Watertown, MA, 24725091.
What is Audrey Susan Wagner's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Audrey Susan Wagner is Internal Medicine, and the taxonomy code that categorizes this field of expertise is 207R00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1639127152 to Audrey Susan Wagner?
The Centers for Medicare & Medicaid Services originally issued the 1639127152 to Audrey Susan Wagner on 2006-05-05.
As of what date were the Audrey Susan Wagner's details last updated?
The information pertaining to the Audrey Susan Wagner, including its address, specialty, and other details, was most recently updated on 2011-06-27.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY