NPI 1003583642

Nicholas Brennan Wagner, MD

Practitioner Student in an Organized Health Care Education/Training Program Tampa, FL

Practice location

Address: 17 Davis Blvd STE 308, Tampa, FL 33606-3438
Phone: (813) 974-2201

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1003583642
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Aug 2021
Record last updated: 3 May 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.