RICHARD OTTO WAGNER (NPI# 1194752683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194752683 |
| Entity Type | Individual |
| Full Name | RICHARD OTTO WAGNER |
| Credential | MD |
| Practice Address |
N116w17866 Blackstone Cir Germantown WI 53022-5665 |
| Mailing Address |
11995 Singletree Ln Ste 500 Eden Prairie MN 55344-5347 |
| Practice Telephone | 9525951100 |
| Practice Fax Number | 6122944903 |
| Mailing Telephone | 9525951301 |
| Mailing Fax Number | 6122944903 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2018-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
19448-020 | WI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528304334 | Richard Wagner | Counselor | 5132 Mimosa Drive, Bellaire, TX 77401 | 2012-12-26 |
| 1326359423 | Richard Ross Wagner | Pharmacist | 3282 Bethel Rd Se, Port Orchard, WA 98366-5603 | 2010-06-23 |
| 1871814624 | Richard Adam Wagner | Family Medicine | 295 County Hwy. 156, Johnstown, NY 12095-4123 | 2010-06-16 |
| 1134443559 | Richard Alan Wagner | Pharmacist | 23631 Dane Ct, Laguna Niguel, CA 92677-4618 | 2010-03-15 |
| 1043470214 | Richard W Wagner Jr. | Dentist | 123 W Franklin St, Suite 201, Chapel Hill, NC 27516-2524 | 2008-06-11 |
| 1962621631 | Richard Wagner | Specialist | 1789 Rebecca Lane, Coupeville, WA 98239-0339 | 2007-04-24 |
| 1770700957 | Richard M Wagner | Dentist | 1925 South Green Bay Rd, Racine, WI 53406-4654 | 2007-04-19 |
| 1619019676 | Richard Chisholm Wagner | Dentist | 1150 S King St Ste 303, Honolulu, HI 96814-1951 | 2007-02-13 |
| 1134236334 | Richard Laverne Wagner | Psychiatry & Neurology | 12 Benevolent St, Providence, RI 02906-1103 | 2006-08-24 |
| 1669488946 | Richard Wagner | Psychiatry & Neurology | 101 Lions Dr, Suite 119, Barrington, IL 60010-3181 | 2006-07-31 |
| Street Address |
N116W17866 BLACKSTONE CIR |
| City | GERMANTOWN |
| State | WI |
| Zip Code | 53022-5665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831669407 | Margaret Jo Mulder | Chiropractor | W164 N11269 Squire Drive Suite B, Germantown, WI 53022 | 2018-11-27 |
| 1316441579 | Community Home Care Services | Home Health | N112 W16298 Mequon Rd, 127, Germantown, WI 53022 | 2018-03-22 |
| 1811426224 | Wi-care LLC | In Home Supportive Care | W175n11163 Stonewood Drive Ste 220, Germantown, WI 53022 | 2017-06-08 |
| 1134675358 | Kojo Bempong | Anesthesiologist Assistant | Ahcmg Anesthesiology, 4025 North 92nd Street, Wauwatosa, WI 53022 | 2016-08-28 |
| 1336501915 | Ashley Russell | Occupational Therapist | W175 N11117 Stonewood Drive, Suite 100, Germantown, WI 53022 | 2016-03-23 |
| 1134535735 | Erin Therese Grueneberg | Nurse Practitioner | W153 N9990 Neptune Drive, Germantown, WI 53022 | 2014-07-03 |
| 1306286836 | Kyle W Mcmahon | Occupational Therapist | W175 N1117 Stonewood Drive, Suite 100, Germantown, Wi, WI 53022 | 2013-06-28 |
| 1326354713 | Brittany Skogg | Physical Therapist | W175 W11117 Stonewood Dr., Suite 100, Germantown, WI 53022 | 2010-08-24 |
| 1669635066 | Joseph D Deguzman Dds Ms Sc | Clinic/Center | W172 N9723 Division Road, Suite A, Germantown, WI 53022 | 2008-07-07 |
| 1457513988 | Rustin A. West | Dentist | W172 N9723 Division Road Suite A, Germantown, WI 53022 | 2008-06-26 |
| Find all providers in zip 53022 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871931667 | Sam Wairiri | Radiology | 1458 Grove Meadow Ct, Germantown, TN 38138-3307 | 2013-06-13 |
| 1811158967 | Reem Saadeh Awwad | Radiology | 8692 Somerset Ln, Germantown, TN 38138-7309 | 2008-06-20 |
| 1639369531 | Diagnostic Ultrasound Consultants | Radiology | 1300 Wolf Park Dr, Germantown, TN 38138-1741 | 2007-07-26 |
| 1528012119 | Germantown Outpatient Imaging, LLC | Radiology | 19731 Germantown Rd, Suite 102, Germantown, MD 20874-1203 | 2006-05-19 |
| 1518954759 | Gregory J S Lewis | Radiology | 7600 Wolf River Blvd, Ste 200, Germantown, TN 38138 | 2005-10-03 |
| 1114920394 | Jennifer R Boals | Radiology | 7695 Poplar Pike, Suite 101, Germantown, TN 38138-5947 | 2005-05-23 |
| 1578566741 | Robert L Cockroft | Radiology | 2683 Forest Hill Irene Rd, Germantown, TN 38139-7805 | 2005-05-23 |
| 1912395708 | West Tennessee Imaging, LLC | Radiology | 7600 Wolf River Blvd, Suite 100, Germantown, TN 38138-1744 | 2014-12-31 |
| 1760826788 | Kelly Ford | Radiology | 7695 Poplar Pike Ste 101, Germantown, TN 38138-5947 | 2013-04-21 |
| 1154764462 | Christopher Bates | Radiology | 7695 Poplar Pike Ste 101, Germantown, TN 38138-5947 | 2013-04-17 |
| Find all providers in GERMANTOWN | ||||
| City | GERMANTOWN |
| Zip Code | 53022 |
Please comment or provide details below to improve the information on RICHARD OTTO WAGNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.