Charles J Wagner (NPI# 1366540742, PAC ID# 1254425531) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ALLERGY/IMMUNOLOGY.
| Nation Provider ID (NPI) | 1366540742 |
| PAC ID by PECOS | 1254425531 |
| Professional Enrollment ID | I20120607000724 |
| Full Name | Charles J Wagner |
| Organization Legal Name | SILVER FALLS DERMATOLOGY PC |
| Address |
1793 13th St Se Salem OR 97302-2541 |
| Phone Number | 5033628385 |
| Gender | M |
| Medical School | UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE |
| Graduation Year | 1975 |
| Primary Specialty | ALLERGY/IMMUNOLOGY |
| Group Practice PAC ID | 5890863492 |
| Number of Group Practice Members | 43 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380051 | SALEM HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1793 13th St Se, Salem, OR 97302-2541 | 5033628385 | SILVER FALLS DERMATOLOGY PC |
| Organization Legal Name | SILVER FALLS DERMATOLOGY PC |
| Physicians | 46 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Megan Elizabeth Smith | Physician Assistant | Silver Falls Dermatology PC | 375 Park Ave, Suite 5, Coos Bay, OR 97420-2242 |
| Lauren E Boudreaux | Dermatology | Silver Falls Dermatology PC | 831 Nw Council Dr, Suite 301, Gresham, OR 97030-3725 |
| Patricia Ann Stewart | Dermatology | Silver Falls Dermatology PC | 700 S 320 St A, Federal Way, WA 98003-5254 |
| Elizabeth Schmidt | Physician Assistant | Silver Falls Dermatology PC | 375 Se Norton Ln C, Mcminnville, OR 97128-8484 |
| Ladessa Christensen | Nurse Practitioner | Silver Falls Dermatology PC | 685 Evergreen Rd Ne, Woodburn, OR 97071-2910 |
| Rick D Pittman | Vascular Surgery | Silver Falls Dermatology PC | 1793 13th St Se, Salem, OR 97302-2541 |
| Sandra Hadenfeld | Nurse Practitioner | Silver Falls Dermatology PC | 1006 N H St 3rd Floor, Aberdeen, WA 98520-2599 |
| Mark D Williams | Physician Assistant | Silver Falls Dermatology PC | 1390 Waverly Dr Se, Albany, OR 97322-6945 |
| Anna Delaine Dodd | Nurse Practitioner | Silver Falls Dermatology PC | 831 Nw Council Dr, Suite 301, Gresham, OR 97030-3725 |
| Whitney Fancher | Dermatology | Silver Falls Dermatology PC | 831 Nw Council Dr, Suite 301, Gresham, OR 97030-3725 |
| Street Address |
1793 13TH ST SE |
| City | SALEM |
| State | OR |
| Zip | 97302-2541 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rick D Pittman | Vascular Surgery | Silver Falls Dermatology PC | 1793 13th St Se, Salem, OR 97302-2541 |
| Karsten Johnson | Dermatology | Silver Falls Dermatology PC | 1793 13th St Se, Salem, OR 97302-2541 |
| Constance Lee Hayes | Nurse Practitioner | Silver Falls Dermatology PC | 1793 13th St Se, Salem, OR 97302-2541 |
| Todd L Knapp | Dermatology | Silver Falls Dermatology PC | 1793 13th St Se, Salem, OR 97302-2541 |
| Brolin Johnson | Physician Assistant | Silver Falls Dermatology PC | 1793 13th St Se, Salem, OR 97302-2541 |
| Charity Capuras | Nurse Practitioner | Silver Falls Dermatology PC | 1793 13th St Se, Salem, OR 97302-2541 |
| Jennifer Robin Smith | Nurse Practitioner | Silver Falls Dermatology PC | 1793 13th St Se, Salem, OR 97302-2541 |
| William Lear | Dermatology | Silver Falls Dermatology PC | 1793 13th St Se, Salem, OR 97302-2541 |
| Stephanie Juliet Campbell | Dermatology | Silver Falls Dermatology PC | 1793 13th St Se, Salem, OR 97302-2541 |
| Jennifer Renee Kasselmann | Nurse Practitioner | Silver Falls Dermatology PC | 1793 13th St Se, Salem, OR 97302-2541 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dorothy Jean Anderson | Psychologist, Clinical | 2264 Mcgilchrist St Se, Suite 100, Salem, OR 97302-1008 | |
| Bill L Hennings | Psychologist, Clinical | 2264 Mcgilchrist St Se, Suite 100, Salem, OR 97302-1008 | |
| Gabriel M Kennedy | Oral Surgery | Howerton, Hopkin and Kennedy LLC | 2266 Mission St Se, Salem, OR 97302-1267 |
| Joel K Hopkin | Oral Surgery | Howerton, Hopkin and Kennedy LLC | 2266 Mission St Se, Salem, OR 97302-1267 |
| Jev A Clark | Oral Surgery | Howerton, Hopkin and Kennedy LLC | 2266 Mission St Se, Salem, OR 97302-1267 |
| David Wesley Howerton | Oral Surgery | Howerton, Hopkin and Kennedy LLC | 2266 Mission St Se, Salem, OR 97302-1267 |
| Tyler Spalding Manson | Podiatry | Santiam Foot Clinic PC | 2235 Mission St Se, Suite 150, Salem, OR 97302-1294 |
| John T Callahan | Podiatry | Santiam Foot Clinic PC | 2235 Mission St Se, Suite 150, Salem, OR 97302-1294 |
| Barbara M Balowitz | Clinical Social Worker | 4035 12th St Cut Off Se, Suite 140, Salem, OR 97302-1754 | |
| Jennifer Carley | Nurse Practitioner | 4035 12th St Cutoff Se, Suite 120, Salem, OR 97302-1754 | |
| Find all physicians in zip 97302 | |||
| City | SALEM |
| Zip Code | 97302 |
| Specialty | ALLERGY/IMMUNOLOGY |
| City + Specialty | SALEM + ALLERGY/IMMUNOLOGY |
Please comment or provide details below to improve the information on Charles J Wagner.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.