| NPI Details | |
|---|---|
| NPI | 1083663272 |
| Gender | Female |
| Enumeration Date | 05/08/2006 |
| Last Updated | 07/08/2007 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 5455 MERIDIAN MARK RD NE STE 400 ATLANTA GA, 30342, US |
|
| Phone | (404) 785-3240 |
| Fax | (404) 785-3600 |
| Business Location | |
|---|---|
| 5455 MERIDIAN MARK RD NE STE 400 ATLANTA GA, 30342, US |
|
| Phone | (404) 785-3240 |
| Fax | (404) 785-3600 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 103T00000X |
| License State | Georgia |
| License Number | 001706 |
| Remove 1083663272 NPI Number | |
According to our database, Brenda J Wagner PHD NPI is 1083663272, taxonomy code is 103T00000X and license number is 001706, license state is located at Georgia. Brenda J Wagner PHD physically located at 5455 Meridian Mark Rd Ne, Atlanta GA, 30342. NPI Number Brenda J Wagner PHD has the Individual type.
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1083663272 NPI number is provided on an as is basis without warranty of any kind. 1083663272 is maintained by the National Plan & Provider Enumeration System. The contents of Brenda J Wagner PHD are for informational purposes only.
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