Jesse Wagner, M.D. Valid NPI

Individual provider · Internal Medicine Physician · Middletown, CT

NPI

1528048428

Type

Individual (Type 1)

Primary specialty

Internal Medicine Physician (Internal Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207R00000X

License number

036836 (CT)

Sex

Male

Sole proprietor

No

Enumerated

2006-01-18

Last updated

2009-11-11