Gregory Alan Wagoner in Chestnut Hill - Internal Medicine
Gregory Alan Wagoner - NPI 1700965324
Gregory Alan Wagoner is a Internal Medicine in Chestnut Hill, Massachusetts. Gregory Alan Wagoner practices all healthcare services and medical treatments related to Internal Medicine. The NPI Number for Gregory Alan Wagoner is 1700965324. The last update date is 2007-07-08.
Gregory Alan Wagoner's current location address is 119 Commonwealth Ave, Chestnut Hill, Massachusetts. You can contact this provider via phone number 6179645754 and fax number 6174147776. The mailing address for Gregory Alan Wagoner is 119 Commonwealth Ave, Chestnut Hill, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gregory Alan Wagoner |
|---|---|
| Address | 119 Commonwealth Ave, Chestnut Hill, Massachusetts |
| Phone Number | 6179645754 |
| Fax Number | 6174147776 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1700965324 |
|---|---|
| Provider Enumeration Date | 2006-11-03 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 119 Commonwealth Ave |
|---|---|
| City | Chestnut Hill |
| State | Massachusetts (MA) |
| Post Code | 24671004 |
| Phone Number | 6179645754 |
| Fax Number | 6174147776 |
Provider's Primary Taxonomy Detail
| Speciality | Internal Medicine |
|---|---|
| Taxonomy | 207R00000X |
| Licence No | 38544 |
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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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What is the unique identifier code issued to Gregory Alan Wagoner by the Centers for Medicare & Medicaid Services?
The Gregory Alan Wagoner has been assigned the NPI (National Provider Identifier) 1700965324. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Gregory Alan Wagoner is located?
The Gregory Alan Wagoner is situated at the following address: 119 Commonwealth Ave, Chestnut Hill, MA, 24671004.
What is the area of specialization for Gregory Alan Wagoner, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Gregory Alan Wagoner is Internal Medicine, and the corresponding taxonomy code that categorizes this area of expertise is 207R00000X.
On what date did Gregory Alan Wagoner receive its 1700965324 assignment from the Centers for Medicare & Medicaid Services?
The Gregory Alan Wagoner was assigned its 1700965324 on 2006-11-03, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Gregory Alan Wagoner's details last updated?
The information pertaining to the Gregory Alan Wagoner, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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