| NPI | 1649362948 |
|---|---|
| Former Legal Business Name | NELL ANN WAGONER, M.D., P.C. |
| Entity Type | Organization |
| Authorized Contact | NICHOLAS D NEWBURY Owner 907-586-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: AK 2531) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2017-07-29 |