Dr Joanne E Wagner, MD | |
11130 Capital Blvd, Wake Forest, NC 27587-4513 | |
(919) 488-4094 | |
(919) 488-4096 |
Full Name | Dr Joanne E Wagner |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 11130 Capital Blvd, Wake Forest, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134189251 | NPI | - | NPPES |
89135YM | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 200300536 (North Carolina) | Primary |
Entity Name | Private Diagnostic Clinic Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457389033 PECOS PAC ID: 1355254368 Enrollment ID: O20031204000577 |
Entity Name | Duke Health Integrated Practice Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205553369 PECOS PAC ID: 8325412737 Enrollment ID: O20230327002247 |
Mailing Address | Practice Location Address |
---|---|
Dr Joanne E Wagner, MD 260 Horizon Dr, Raleigh, NC 27615-4922 Ph: (919) 488-0015 | Dr Joanne E Wagner, MD 11130 Capital Blvd, Wake Forest, NC 27587-4513 Ph: (919) 488-4094 |
Dr. Aarthi S Agaram, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1655 Wake Dr Unit 101, Wake Forest, NC 27587 Phone: 919-556-4779 Fax: 919-556-5277 | |
Dr. Jeffrey B Perrin, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 11130 Capital Blvd, Wake Forest, NC 27587 Phone: 919-488-4094 Fax: 919-488-4096 | |
Sarah Young Gessner, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1655 Wake Dr, Suite 101, Wake Forest, NC 27587 Phone: 919-556-4779 Fax: 919-556-5277 | |
Dr. Christian Nechyba, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3000 Rogers Rd Ste 210, Wake Forest, NC 27587 Phone: 919-385-2120 Fax: 919-385-2144 | |
Heather Braddock Acevedo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1655 Wake Dr Unit 101, Wake Forest, NC 27587 Phone: 919-556-4779 Fax: 919-556-5277 | |
Dr. Dirk Hamp, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 11130 Capital Blvd, Wake Forest, NC 27587 Phone: 919-488-4094 Fax: 919-488-4096 | |
Dr. James M Poole, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 11130 Capital Blvd, Wake Forest, NC 27587 Phone: 919-488-4094 Fax: 919-488-4096 |