JESSE WAGNER

MIDDLETOWN, CT
NPI1528048428
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: CT  036836)
Additional Taxonomies208M00000X Hospitalist
(Licence: CT  036836)
Enumeration Date2006-01-18
Last Update Date2009-11-11
Business Address
-- JESSE WAGNER M.D.
28 CRESCENT ST
MIDDLETOWN, CT 06457-3654
Phone number: 860-358-4720
Mailing Address
-- JESSE WAGNER M.D.
28 CRESCENT ST
MIDDLETOWN, CT 06457-3654
Phone number: 860-358-4720