Mary Agnes Wagas, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Marlton, NJ
NPI 1194518282 · NPPES record last updated May 22, 2025
Key facts
- NPI
- 1194518282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 125 Route 70 E Apt 4102
Marlton, NJ 08053-1884 - Phone
- (562) 607-4654
- NPI assigned
- May 22, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
125 Route 70 E Apt 4102
Marlton, NJ 08053-1884
Mailing address
125 Route 70 E Apt 4102
Marlton, NJ 08053-1884
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All providers in Marlton, NJ · Student in an Organized Health Care Education/Training Program in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.