NPI 1922259134

Kristopher M.G. Wagner-Porter, MD

Practitioner General Practice Physician Whiteman Afb, MO

Practice location

Address: 331 Sijan Ave, Whiteman Afb, MO 65305-1269
Phone: (666) 687-2252

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 01065866A (IN)

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Registry record

NPI: 1922259134
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Oct 2008
Record last updated: 7 Oct 2008

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.