Edward Steven Wagner, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME68203 Issued in FL

Practice address

4330 Sheridan St
Ste 101
Hollywood, FL 33021

Phone

(954) 962-9802

Fax

(954) 962-2233

NPI assigned

Feb 9, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1568435741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 SHERIDAN ST",
            "address_2": "STE 101",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-962-9802",
            "fax_number": "954-962-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 SHERIDAN ST",
            "address_2": "STE 101",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-962-9802",
            "fax_number": "954-962-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "EDWARD",
        "middle_name": "STEVEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME68203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379684100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paula H Vulcain, L.M.T.
• Michel Vulfovich, M.D.
• Trinh Le Vuong, PHARM.D.
• Dylan Ambrose Wadell, MD
• Abraham Wagner, DPM
• Jason Fredrick Wagner, APRN, LMHC, MCAP
• William Wagner, M.D.
• Estrella N/a Wahnich
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP

• Obstetrics & Gynecology Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.