Doctor Name: | STEPHEN IRWIN WAGNER |
NPI Number: | 1023009461 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME15542 |
Business Practice Address: | 401 Oakfield Dr Brandon, FL - 335115710 |
Business Phone Number: | 8136542273 |
Business Fax Number: | 8136541384 |
Mailing Address: | 505 Oakfield Dr, BRANDON |
State: | FL |
Postal Code: | 335115700 |
Phone Number: | 8136542273 |
Fax Number: | 8136541384 |
NPI Enumeration Date: | 11/03/2005 |
NPI Last Update Date: | 02/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | ME15542 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |