DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. DRUE O. WAGNER, M.D.

Active Sole Proprietor

DR. DRUE O. WAGNER, M.D. is a Family Medicine healthcare provider located in MOSCOW, Idaho. NPI 1891918629 is currently active in the NPPES registry. Verify at CMS.

Family Medicine · MOSCOW, ID

Registration Details

NPI Number
1891918629
Provider Type
Individual
Gender
Male
NPI Issued
Apr 10, 2007 (19.348590525183 yrs)
Last Updated
Feb 4, 2019
Licenses
00028927 (WA)
M-11013 (ID)
Sole Proprietor
Yes

Practice Information

Address
619 S WASHINGTON ST
SUITE 203
MOSCOW, ID, 838433090
Browse ID providers · Browse ZIP 83843
Phone
2088921346
Fax
2088928306
Primary Specialty
Family Medicine
207Q00000X
Additional Specialty
Family Medicine

Other Family Medicine Providers in MOSCOW, ID

Name Credential NPI
PATRICIA N. MARCIANO M.D. 1053398578
WAYNE LAVERN RUBY MD 1285607085
DAVID D SHUPE MD 1306819115
FRANCIS KERK SPAIN MD 1669445474
ROBERT MANUEL TING MD 1992778708
GLENN DAVID RYCH MD 1013981604
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.