RICHARD WAGONER, M.D.
Internal Medicine
Active
Individual
NPI: 1861458952
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Internal Medicine | 207R00000X | Yes | 036104579 (IL) |
Frequently Asked Questions
NPI 1861458952 is the National Provider Identifier for RICHARD WAGONER, M.D., a Internal Medicine provider located in Havana, IL. This NPI was enumerated on April 26, 2006.
RICHARD WAGONER, M.D. practices at 615 N PROMENADE ST, Havana, IL 62644.
Quick Facts
- NPI
- 1861458952
- Type
- Individual
- Enumerated
- Apr 26, 2006
- Last Updated
- Jun 1, 2012
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