IndividualActive
Jaime Wagner, D.O.
NPI 1306021704 · Vascular & Interventional Radiology Physician · Greensboro, NC
Provider details
- NPI number
- 1306021704
- Entity type
- Individual
- Primary specialty
- Vascular & Interventional Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 162768 (OR)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Student, Health Care
Practice location
1331 N Elm St Ste 200
Greensboro, NC 27401-6304
Phone: (336) 274-9617
Fax: (336) 482-2177
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 63112
Charlotte, NC 28263-3112
Registry dates
- Enumerated
- 2008-01-03
- Last updated
- 2023-03-10
- Certified
- 2023-03-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.