Luke Andrew Wagner, SOIDC

NPI #1013589407 in Coronado, California

Provider Information

NPI Number: 1013589407
Entity Type: Individual
Name: Luke Andrew Wagner, SOIDC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Military Health Care Provider - Independent Duty Corpsman
Credential: SOIDC
Enumeration Date: Jul 14, 2021
Last Updated: Jul 14, 2021

Practice Location

Address: 917 3RD ST
City: Coronado
State: California
ZIP Code: 92118-1313
Phone: (305) 793-4777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman	1710I1002X	Primary

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