Individual provider · Type 1 NPI
Mark Andrew Wagner, DO
Diagnostic Radiology Physician · Madera, CA
NPI number
1336130087
Active
Practice location
36680 Cloverleaf Ave
Madera, CA 93636-8519
Fax (209) 720-0107
Mailing address
4301 Northstar Way
Modesto, CA 95356-9262
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Diagnostic Radiology Physician Primary | 2085R0202X | 20A5259 (CA) |
Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Other diagnostic radiology physician providers in Madera
About NPI 1336130087
Mark Andrew Wagner, DO's National Provider Identifier is 1336130087, issued on Nov 2, 2005. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Madera, CA. The record was last updated on Jun 24, 2024.