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1558324962
MICHAEL ROBERT WAGNER
PORTSMOUTH, VA
NPI
1558324962
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084N0400X Psychiatry & Neurology, Neurology
(Licence: VA 0101048398)
Enumeration Date
2006-04-07
Last Update Date
2007-07-08
Business Address
Dr. MICHAEL ROBERT WAGNER MD
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708-2111
Phone number: 757-953-2114
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Mailing Address
Dr. MICHAEL ROBERT WAGNER MD
1337 ROCKBRIDGE AVE
NORFOLK, VA 23508-1339
Phone number: 757-489-0133
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