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NPI Code Detail

MEDICARE: DR. JOHN WAGDY FAM M.D.

MEDICARE: DR. JOHN WAGDY FAM 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
1208600000XSurgery PhysicianMD460652PA

General Provider Information

NPI Number : 1134488687
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN WAGDY FAM M.D.
Provider Business Mailing Address
First Line : 1220 BROADCASTING RD STE 100
Second Line :
City : WYOMISSING
State : PA
Zip : 19610-3221
Country : US
Telephone Number : 484-628-5673
Fax Number :
Provider Business Practice Location Address
First Line : 1220 BROADCASTING RD STE 100
Second Line :
City : WYOMISSING
State : PA
Zip : 19610-3221
Country : US
Telephone Number : 484-628-5673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2012
Last Update Date : 02/03/2021

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Directions to “ DR. JOHN WAGDY FAM M.D.” Practice Location

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