| NPI | 1639752553 |
|---|---|
| Former Legal Business Name | ANDREW WAGNER MD PC |
| Entity Type | Organization |
| Authorized Contact | BRUCE ALLEN JOHNSON Vice President 303-589-4149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2024-01-17 |