Dr MARY L HUNTLEY WAGNER is a female medical professional, specializing in Nurse Practitioner. She graduated in 2009.
TIDEWATER PHYSICIANS MULTISPECIALTY GROUP, PC
860 OMNI BLVD
NEWPORT NEWS
VA
236064430
Tel:
| Npi | 1376775098 |
| Pac Id | 9830313170 |
| Professional Enrollment Id | I20160526002556 |
| Last Name | HUNTLEY WAGNER |
| First Name | MARY |
| Middle Name | L |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2009 |
| Primary Specialty | NURSE PRACTITIONER |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | TIDEWATER PHYSICIANS MULTISPECIALTY GROUP, PC |
| Group Practice Pac Id | 2860398526 |
| Number Of Group Practice Members | 228 |
| Line 1 Street Address | 860 OMNI BLVD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | Y |
| City | NEWPORT NEWS |
| State | VA |
| Zip Code | 236064430 |
| Phone Number | |
| Hospital Affiliation Ccn 1 | 490057 |
| Hospital Affiliation Lbn 1 | SENTARA VIRGINIA BEACH GENERAL HOSPITAL |
| Hospital Affiliation Ccn 2 | 490046 |
| Hospital Affiliation Lbn 2 | SENTARA LEIGH HOSPITAL |
| Hospital Affiliation Ccn 3 | 490119 |
| Hospital Affiliation Lbn 3 | SENTARA PRINCESS ANNE HOSPITAL |
| Hospital Affiliation Ccn 4 | 490007 |
| Hospital Affiliation Lbn 4 | SENTARA NORFOLK GENERAL HOSPITAL |
| Hospital Affiliation Ccn 5 | 490011 |
| Hospital Affiliation Lbn 5 | BON SECOURS DEPAUL MEDICAL CENTER |
| Professional Accepts Medicare Assignment | Y |
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