Robert John Wagner Jr. (NPI# 1164419081, PAC ID# 0244286656) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1164419081 |
| PAC ID by PECOS | 0244286656 |
| Professional Enrollment ID | I20050329000990 |
| Full Name | Robert John Wagner Jr. |
| Organization Legal Name | SURGICAL ASSOCIATES CHARTERED |
| Address |
5 Garrett Ave La Plata MD 20646-5960 |
| Phone Number | 2404271620 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1998 |
| Primary Specialty | GENERAL SURGERY |
| Secondary Specialties | VASCULAR SURGERY |
| Group Practice PAC ID | 2365412699 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 5801 Allentown Rd, Suite 502, Camp Springs, MD 20746-4653 | 2404271630 | SURGICAL ASSOCIATES CHARTERED |
| 5801 Allentown Rd, Suite 502, Camp Springs, MD 20746-4653 | 3018700660 | PHILIP WISOTSKY M.D., P.C. |
| 5 Garrett Ave, La Plata, MD 20646-5960 | 2404271620 | SURGICAL ASSOCIATES CHARTERED |
| 11370 Pembrooke Sq, Waldorf, MD 20603-4842 | 3018700660 | PHILIP WISOTSKY M.D., P.C. |
| 11650 Doolittle Dr, Waldorf, MD 20602-3804 | 3018900660 | PHILIP WISOTSKY M.D., P.C. |
| Organization Legal Name | SURGICAL ASSOCIATES CHARTERED |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jacques A Zephirin | General Surgery | Surgical Associates Chartered | 7503 Surratts Rd, Clinton, MD 20735-3358 |
| James Tzeng | Thoracic Surgery | Surgical Associates Chartered | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Karl S Salman | Endocrinology | Surgical Associates Chartered | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Shaunna S Dolby | Nurse Practitioner | Surgical Associates Chartered | 5801 Allentown Rd, Suite 502, Camp Springs, MD 20746-4653 |
| Rodeen Rahbar | Vascular Surgery | Surgical Associates Chartered | 5801 Allentown Rd, Suite 502, Camp Springs, MD 20746-4653 |
| Pamela A Odle | Nurse Practitioner | Surgical Associates Chartered | 7503 Surratts Rd, Clinton, MD 20735-3358 |
| Joseph A Bastien | Vascular Surgery | Surgical Associates Chartered | 7503 Surratts Rd, Clinton, MD 20735-3358 |
| Gary Grover | Vascular Surgery | Surgical Associates Chartered | 7503 Surratts Rd, Clinton, MD 20735-3358 |
| Street Address |
5 GARRETT AVE |
| City | LA PLATA |
| State | MD |
| Zip | 20646-5960 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chelsea Dawn Hughes | Physician Assistant | Mdics At Civista LLC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Sudhakar Vl Devathi | Hospitalist | Mdics At Civista LLC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Shalender Saini | Hospitalist | Mdics At Civista LLC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| James Tzeng | Thoracic Surgery | Surgical Associates Chartered | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Vijayasimha Pothula | Anesthesiology | Maryland Anesthesia and Pain Management Services PC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Rachel P Stewart Johnson | Certified Registered Nurse Anesthetist (crna) | Maryland Anesthesia and Pain Management Services PC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Seid Aminu | Hospitalist | Mdics At Civista LLC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Darrell E Lewis | Anesthesiology | Maryland Anesthesia and Pain Management Services PC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Matthew Peter Dattwyler | Diagnostic Radiology | University of Maryland Diagnostic Imaging Specialists, Pa | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Rebika Bijukchhe | Hospitalist | Mdics At Civista LLC | 5 Garrett Ave, La Plata, MD 20646-5960 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frank Alfano | Chiropractic | 203 Centennial St, Suite 105, La Plata, MD 20646-2741 | |
| Megan N Shroyer | Physician Assistant | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Kirandeep Kaur | Internal Medicine | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Taana P Viviano | Internal Medicine | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Farhana B Syed | General Practice | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Juachi I Mbah | Nurse Practitioner | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Michael J Warren | Nurse Practitioner | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Ted Howe | Pediatric Medicine | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Josjin Vazhappilly | Internal Medicine | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Virginia A Noftsier | Physician Assistant | Mdics Rehabilitative Services LLC | 10200 La Plata Rd, La Plata, MD 20646-3245 |
| Find all physicians in zip 20646 | |||
| City | LA PLATA |
| Zip Code | 20646 |
| Specialty | GENERAL SURGERY |
| City + Specialty | LA PLATA + GENERAL SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.