Dr Matthew Steven Wagner, MD | |
420 E 1st St, Duluth, MN 55805-1901 | |
(218) 786-8364 | |
Not Available |
Full Name | Dr Matthew Steven Wagner |
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Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 420 E 1st St, Duluth, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164918199 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 74110 (Minnesota) | Primary |
207R00000X | Internal Medicine | RL15231 (North Dakota) | Secondary |
Entity Name | The Duluth Clinic Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902563638 PECOS PAC ID: 2567374283 Enrollment ID: O20031103000229 |
Mailing Address | Practice Location Address |
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Dr Matthew Steven Wagner, MD 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-8364 | Dr Matthew Steven Wagner, MD 420 E 1st St, Duluth, MN 55805-1901 Ph: (218) 786-8364 |
Bruce James Derauf, Radiology Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-8364 | |
Mrs. Rebecca Lynn Kuntz, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 925 E Superior St, Suite 109, Duluth, MN 55802 Phone: 218-722-3700 Fax: 218-722-8705 | |
Kenneth Dornfeld, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 400 East 3rd Street, Duluth, MN 55805 Phone: 218-786-8364 | |
Dr. William E. Johnson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 925 E Superior St, Suite109, Duluth, MN 55802 Phone: 218-722-3700 Fax: 218-722-8705 | |
Dr. Ryan Patrick Wippler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 420 E 1st St, Duluth, MN 55805 Phone: 218-786-8364 | |
Michael Edward Ryan, Radiology Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-8364 |