Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRADFORD S. WAGNER, MD
ActiveSports Medicine · SOUTH PORTLAND, ME
Registration Details
- NPI Number
- 1083848030
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 6, 2009 (16.979717984982 yrs)
- Last Updated
- Mar 3, 2026
- Licenses
-
MD19486 (ME)MD19486 (ME)
Practice Information
- Address
-
50 FODEN RD STE 3SOUTH PORTLAND, ME, 041061718Browse ME providers · Browse ZIP 04106
- Phone
- 2078741489
- Fax
- 2075238590
- Primary Specialty
-
Sports Medicine
207QS0010X
- Additional Specialty
- Sports Medicine
Other Sports Medicine Providers in SOUTH PORTLAND, ME
| Name | Credential | NPI |
|---|---|---|
| ALLYSON S. HOWE | MD | 1679662563 |
| HEATHER M GILLESPIE | MD | 1861561581 |
| DR. TIMOTHY MCATEER | MD | 1619042595 |
| DR. JOHN P COLIANNI | M.D. | 1336264316 |
| DR. KRYSTIAN W BIGOSINSKI | MD | 1245450832 |
| DR. KATE E QUINN | D.O. | 1689979502 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.