Individual provider · Type 1 NPI
Matthew Robert Wagner, MD
Pediatric Orthopaedic Surgery Physician · Port Jefferson Station, NY
Practice location
1500 Route 112 Bldg 2C
Port Jefferson Station, NY 11776-8055
Fax (631) 828-7899
Other practice locations
- 500 Commack Rd Unit 150, Commack, NY 11725-5009 · (631) 371-8034
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Orthopaedic Surgery Physician | 207XP3100X | ME103612 (FL) |
| Pediatric Orthopaedic Surgery Physician Primary | 207XP3100X | 251727 (NY) |
Pediatric Orthopaedic Surgery Physician: An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones.
Another provider at this address
About NPI 1114198751
Matthew Robert Wagner, MD's National Provider Identifier is 1114198751, issued on Mar 21, 2008. The primary taxonomy on file is Pediatric Orthopaedic Surgery Physician (207XP3100X), and the practice location is in Port Jefferson Station, NY. The record was last updated on Nov 5, 2019.