NPI 1013060896

Diana H Wagman, PAC

Practitioner Physician Assistant Portland, ME

Practice location

Address: 33 Sewall St, Portland, ME 04102-2603
Phone: (207) 828-2100
Mailing address: 324 Gannett Dr STE 200, South Portland, ME 04106-3266

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA260 (ME)

Other Physician Assistant providers in Maine →

Registry record

NPI: 1013060896
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Jan 2007
Record last updated: 11 Nov 2015

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.