PETER WAGNER (NPI# 1245440841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245440841 |
| Entity Type | Individual |
| Full Name | PETER WAGNER |
| Credential | MD |
| Practice Address |
350 Heritage Way Suite 1100 Kalispell MT 59901-3158 |
| Practice Telephone | 4067528900 |
| Practice Fax Number | 4067528909 |
| Mailing Telephone | 4067528900 |
| Mailing Fax Number | 4067528909 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
12637 | MT | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
PENDING | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 04208790 | 05 | |
| DEA | FW0235108 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235676008 | Peter Louis Wagner | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2017-01-31 |
| 1285995100 | Peter J Wagner | Orthopaedic Surgery | 2 Dudley St Ste 200, Providence, RI 02905 | 2012-06-07 |
| 1609992932 | Peter C. Wagner | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2007-03-21 |
| 1548356280 | Peter Louis Wagner | Dentist | 10535 N Port Washington Rd, Suite 102, Mequon, WI 53092-5583 | 2006-10-04 |
| 1174531388 | Peter William Wagner | Surgery | 30 W Mccreight Ave, Suite 208, Springfield, OH 45504-1842 | 2006-08-03 |
| 1598734196 | Peter B Wagner | Internal Medicine | 600 Moye Blvd, Greenville, NC 27834-4300 | 2006-03-16 |
| 1659341865 | Peter C Wagner | Family Medicine | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2006-01-23 |
| 1396729539 | Peter J Wagner | Internal Medicine | 1221 Whipple St, Eau Claire, WI 54703-5270 | 2005-12-01 |
| 1962403774 | Peter John Wagner | Psychiatry & Neurology | 39700 Bob Hope Dr, Suite 216, Rancho Mirage, CA 92270-3267 | 2005-08-02 |
| Street Address |
350 HERITAGE WAY SUITE 1100 |
| City | KALISPELL |
| State | MT |
| Zip Code | 59901-3158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718389 | Drew L. Kirshner | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 350 Heritage Way, Ste 2100, Kalispell, MT 59901-3158 | 2005-05-31 |
| 1154693729 | Alyssa M. Stone | Physician Assistant | 350 Heritage Way, Suite 2100, Kalispell, MT 59901-3158 | 2012-01-30 |
| 1285904599 | Kalispell Regional Medical Center Inc | Clinic/Center | 350 Heritage Way, Suite 1100, Kalispell, MT 59901-3158 | 2012-01-03 |
| 1235409640 | Kalispell Regional Medical Center Inc | Clinic/Center | 350 Heritage Way, Suite 2100, Kalispell, MT 59901-3158 | 2012-01-03 |
| 1053688705 | Raymond Tabo Saito | Physician Assistant | 350 Heritage Way, Suite 1200, Kalispell, MT 59901-3158 | 2011-11-23 |
| 1962705376 | Kalispell Regional Medical Center Inc | Internal Medicine | 350 Heritage Way, Suite 1100, Kalispell, MT 59901-3158 | 2010-12-08 |
| 1497065072 | Kim T Conlin | Physician Assistant | 350 Heritage Way, Suite 2300, Kalispell, MT 59901-3158 | 2010-10-15 |
| 1871824219 | Shannon K Lee | Physician Assistant | 350 Heritage Way, Suite 1200, Kalispell, MT 59901-3158 | 2010-01-25 |
| 1396978128 | Rawa Sarji | Internal Medicine | 350 Heritage Way, Suite 2100, Kalispell, MT 59901-3158 | 2009-08-27 |
| 1659514149 | Mark Erich Magill | Orthopaedic Surgery | 350 Heritage Way, Suite 1200, Kalispell, MT 59901-3158 | 2009-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982226650 | Mountain Physical Therapy and Fitness Center LLC | Physical Medicine & Rehabilitation | 2593 Highway 2 East, Suite 6, Kalispell, MT 59901 | 2020-05-15 |
| 1164058350 | Jessica Leeann Abell | Physical Therapist | 1825 Highway 93 S. Suite C, Kalispell, MT 59901 | 2020-03-19 |
| 1588216535 | Diversified Therapeutic Services, Pllc | Clinic/Center | 30 E Washinton St, Suite A, Kalispell, MT 59901 | 2019-07-10 |
| 1467986216 | Jill Shaver | Counselor | 285 2nd Avenue Wn, Suite #100, Kalispell, MT 59901 | 2017-04-19 |
| 1003270810 | Angela Otto | Counselor | 17 2nd St E Ste 204, Kalispell, MT 59901 | 2016-04-07 |
| 1548626989 | Pamela Greskowiak | Counselor | 2282 Hwy 93 South, Suite #1, Kalispell, MT 59901 | 2016-01-14 |
| 1063894921 | Joel Booth | Dentist | 690 N Meridian Rd Ste 106, Kalispell, MT 59901 | 2015-06-26 |
| 1982085841 | Heather Reddig | Specialist | 751 Snowberry Trail, Kalispell, MT 59901 | 2015-06-16 |
| 1497147193 | Patricia Greene Hall | Psychologist | 1035 1st Ave W Fl 3, Kalispell, MT 59901 | 2015-03-04 |
| 1720478886 | Lori Mariani | Social Worker | 1605 Danielson Road, Kalispell, MT 59901 | 2015-01-28 |
| Find all providers in zip 59901 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891151122 | Kalispell Regional Medical Center Inc | Internal Medicine | 75 Claremont St, Suite E, Kalispell, MT 59901-3585 | 2015-12-31 |
| 1962705376 | Kalispell Regional Medical Center Inc | Internal Medicine | 350 Heritage Way, Suite 1100, Kalispell, MT 59901-3158 | 2010-12-08 |
| 1700971272 | John A Ward | Internal Medicine | 350 Heritage Way, Suite 1100, Kalispell, MT 59901-3158 | 2006-10-03 |
| 1578657193 | Kalispell Medical Oncology, Pllp | Internal Medicine | 350 Heritage Way, Suite 1100, Kalispell, MT 59901 | 2006-10-03 |
| 1861587339 | Karen J Hunt | Internal Medicine | 350 Heritage Way, Suite 1100, Kalispell, MT 59901 | 2006-10-03 |
| 1215022769 | William M Boehme | Internal Medicine | 350 Heritage Way, Suite 1100, Kalispell, MT 59901 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457543340 | Siobhan P Lynch | Internal Medicine | 2837 Fort Missoula Rd, Missoula, MT 59804-7408 | 2007-08-14 |
| 1871672428 | Judy L Schmidt, Md/pc | Internal Medicine | 2835 Fort Missoula Rd., Suite 301, Missoula, MT 59804-7424 | 2006-11-03 |
| 1275541559 | Donald H Berdeaux Md Facp PC | Internal Medicine | 1117 29th St S Ste 400, Great Falls, MT 59405-5309 | 2006-08-03 |
| 1902820483 | Annie L Castillo | Internal Medicine | 915 Highland Blvd # 3220, Bozeman, MT 59715-6902 | 2006-07-27 |
| 1245286970 | Grant W Harrer | Internal Medicine | 1117 29th St. S, Suite 500, Great Falls, MT 59405 | 2006-05-25 |
| 1659629822 | Le Min Lee | Internal Medicine | 801 N 29th St, Billings, MT 59101 | 2012-08-20 |
| 1063788677 | Cesar Ochoa Perez | Internal Medicine | 801 N 29th St, Billings, MT 59101 | 2012-03-28 |
| 1568776771 | Carlos Silva Rondon | Internal Medicine | 801 N 29th St, Billings, MT 59101 | 2010-07-29 |
| 1467681833 | Jesus Carlos Fabregas Mercado | Internal Medicine | 801 N 29th St, Billings, MT 59101-0905 | 2009-07-07 |
| 1205092400 | Courtney Regan Wagner | Internal Medicine | 931 Highland Blvd Ste 3130, Bozeman, MT 59715-6914 | 2008-08-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.