| Scott Wagner Integrated Medicine Llc | |
|
2109 India Rd Charlottesville VA 22901-2886 | |
| (434) 978-4888 | |
| Not Available |
| Full Name | Scott Wagner Integrated Medicine Llc |
|---|---|
| Speciality | General Practice |
| Location | 2109 India Rd, Charlottesville, Virginia |
| Authorized Official Name and Position | Scott Brian Wagner (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4349784888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott Wagner Integrated Medicine Llc 2109 India Rd Charlottesville VA 22901-2886 Ph: (434) 978-4888 | Scott Wagner Integrated Medicine Llc 2109 India Rd Charlottesville VA 22901-2886 Ph: (434) 978-4888 |
| NPI Number | 1447875042 |
|---|---|
| Provider Enumeration Date | 06/10/2020 |
| Last Update Date | 06/20/2023 |
| Medicare PECOS PAC ID | 1153749825 |
|---|---|
| Medicare Enrollment ID | O20220512002622 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447875042 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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