THEODORE T WAGNER

FORT WAYNE, IN
NPI1831162791
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208800000X Urology
(Licence: IN  01050471A)
Enumeration Date2006-02-10
Last Update Date2023-03-21
Business Address
THEODORE T WAGNER MD
11141 PARKVIEW PLAZA DR STE 325
FORT WAYNE, IN 46845-1714
Phone number: 260-425-5400
Mailing Address
THEODORE T WAGNER MD
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number: