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NPI Code Detail

MEDICARE: CHRISTOPHER T WAGNER MD

MEDICARE: CHRISTOPHER T WAGNER MD
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 Physician42414WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528053758
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER T WAGNER MD
Provider Business Mailing Address
First Line : 2000 E MILESTONE DR
Second Line :
City : APPLETON
State : WI
Zip : 54913-6701
Country : US
Telephone Number : 920-731-8131
Fax Number : 920-832-0444
Provider Business Practice Location Address
First Line : 2000 E MILESTONE DR
Second Line :
City : APPLETON
State : WI
Zip : 54913-6701
Country : US
Telephone Number : 920-731-8131
Fax Number : 920-832-0444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2005
Last Update Date : 07/22/2025

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Directions to “ CHRISTOPHER T WAGNER MD” Practice Location

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