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NPI Code Detail

MEDICARE: LLOYD DAVID WAGNER M.D.

MEDICARE: LLOYD DAVID WAGNER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianTM2014-0943NM
22085R0202XDiagnostic Radiology PhysicianMD453925PA
32085R0202XDiagnostic Radiology Physician164449NY
42085R0202XDiagnostic Radiology Physician53879CT
52085R0202XDiagnostic Radiology PhysicianG70226CA
62085R0202XDiagnostic Radiology Physician25MA09610500NJ

General Provider Information

NPI Number : 1124161872
Entity Type Code : Individual
Provider Name (Legal Business Name) : LLOYD DAVID WAGNER M.D.
Provider Business Mailing Address
First Line : 1 FEDERAL ST STE 200
Second Line :
City : CAMDEN
State : NJ
Zip : 08103-1088
Country : US
Telephone Number : 848-288-6935
Fax Number :
Provider Business Practice Location Address
First Line : 1 COOPER PLZ
Second Line :
City : CAMDEN
State : NJ
Zip : 08103-1461
Country : US
Telephone Number : 888-499-8779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2007
Last Update Date : 06/01/2026

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