| Rg Wagner Md Llc | |
|
2160 Fountain Dr Suite D Snellville GA 30078-7022 | |
| (770) 982-7790 | |
| Not Available |
| Full Name | Rg Wagner Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2160 Fountain Dr, Snellville, Georgia |
| Authorized Official Name and Position | Russell G Wagner (M.D.) |
| Authorized Official Contact | 7709827790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rg Wagner Md Llc 2160 Fountain Dr Suite D Snellville GA 30078-7022 Ph: (770) 982-7790 | Rg Wagner Md Llc 2160 Fountain Dr Suite D Snellville GA 30078-7022 Ph: (770) 982-7790 |
| NPI Number | 1548275415 |
|---|---|
| Provider Enumeration Date | 07/29/2006 |
| Last Update Date | 07/20/2009 |
| Medicare PECOS PAC ID | 4587769476 |
|---|---|
| Medicare Enrollment ID | O20070423000065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548275415 | NPI | - | NPPES |
| 000418074E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Russell G Wagner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730168832 PECOS PAC ID: 2769429307 Enrollment ID: I20050414000630 |
| Provider Name | Kimberly Rose Schiavoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114308475 PECOS PAC ID: 3779884606 Enrollment ID: I20151218001774 |
| Provider Name | Shannon Maria Saroka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043664998 PECOS PAC ID: 8022300086 Enrollment ID: I20160712001551 |
Horizons Healthcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2795 Main St W, #27, Snellville, GA 30078 Phone: 770-985-8001 | |
Snellville Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 Tree Ln, Ste 290a, Snellville, GA 30078 Phone: 770-979-1544 Fax: 770-979-5662 | |
Dr. B Abraham Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3020 Highway 124, Snellville, GA 30039 Phone: 770-978-1331 Fax: 770-978-8580 | |
John E. West, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2295 Henry Clower Blvd, Suite 101, Snellville, GA 30078 Phone: 770-972-4871 Fax: 770-979-3782 | |
Fine & Associates Internal Medicine Specialists, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1561 Janmar Rd Ste E, Snellville, GA 30078 Phone: 770-736-8962 Fax: 770-736-8970 | |