1669489829 NPI number — DR. CHRISTOPHER FRANK WAGENER MD

Table of content: STEPHEN ROCHON (NPI 1487414132)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669489829 NPI number — DR. CHRISTOPHER FRANK WAGENER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WAGENER
Provider First Name:
CHRISTOPHER
Provider Middle Name:
FRANK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669489829
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2775 SCHOENERSVILLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18017-7307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-861-8080
Provider Business Mailing Address Fax Number:
610-807-0366

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2775 SCHOENERSVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18017-7307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-861-8080
Provider Business Practice Location Address Fax Number:
610-807-0366
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  MD431921 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110545 . This is a "GEISINGER HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7296913 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1651389 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2849352000 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50070229 . This is a "KEYSTONE HEALTH CENTRAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1967875 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2849352000 . This is a "INDEPENDENCE BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50070229 . This is a "CAPITAL BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 695321 . This is a "HEALTH AMERICA/HEALTH ASS" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00447636 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2685022 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2849352000 . This is a "KEYSTONE HEALTH EAST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9127625 . This is a "CIGNA HEALTHCARE" identifier . This identifiers is of the category "OTHER".




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