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General NPI Number Information
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NPI Number | 1063536282
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Entity Type | Organization
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Legal Business Name | PAMELA D MURPHY & MARK WAGNER PTR
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 623 N 5TH ST
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City | READING
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State | PA
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Zip | 19601-2201
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Country | US
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Telephone | 610-374-8585
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Fax | 610-374-2574
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Provider Business Mailing Address
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Address Line | 623 N 5TH ST
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City | READING
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State | PA
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Zip | 19601-2201
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Country | US
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Telephone | 610-374-8585
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Fax | 610-374-2574
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Authorized Official
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Title or Position | PARTNER
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Name | MARK WAGNER
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Credential | D.O.
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Telephone | 610-374-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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