Thor Wagner

MD | Pediatric Infectious Diseases | Male

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Complete Profile:

Thor Wagner basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Infectious Diseases
Provider Name :	Thor Wagner
Credential :	MD
Gender :	Male

Business Address:

Thor Wagner address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	1959 Ne Pacific St, C212, Box 356340 Seattle, WA, 98195-6340 United States
Phone Number :	206-543-0065

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1447333521
NPI Entity Type :	Individual
First Enrolment Date :	23 Oct, 2006
Last Updated On :	08 Jul, 2007

Medicare Participation:

Thor Wagner participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	7113095845
Medicare Enrollment ID :	I20081008000622
Primary Specialty :	Pediatric Medicine
Medical School :	Temple University School Of Medicine
Graduation Year :	2000
Accepts Medicare?	Yes. Thor Wagner accepts medicare insurance.

Group Practice Association:

Thor Wagner is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Thor Wagner is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
The Association Of Chrmc And University Physicians	9133032964	209	4800 Sand Point Way Ne Seattle, WA - 981053901 Ph: 2065262000	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Thor Wagner are as mentioned. Primary taxonomy code for Thor Wagner, MD is 2080P0208X (Pediatrics Pediatric Infectious Diseases).

Taxonomy Code	Speciality	Primary	License No.	State
2080P0208X	Pediatrics Pediatric Infectious Diseases	Yes	MD00044528	WA

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	1959 Ne Pacific St, C212, Box 356340 Seattle, WA, 98195-6340 United States

Business Location:

Patients can refer following map for directions to Thor Wagner practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.