MARK W WAGNER

CHARLESTON, SC
NPI1508974544
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: SC  15073)
Enumeration Date2006-08-29
Last Update Date2011-09-06
Business Address
MARK W WAGNER MD
171 ASHLEY AVE
CHARLESTON, SC 29425-0001
Phone number: 843-792-1414
Mailing Address
MARK W WAGNER MD
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200
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