Basic Information
Provider Information
NPI: 1669489829
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WAGENER
FirstName: CHRISTOPHER
MiddleName: FRANK
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2775 SCHOENERSVILLE RD
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180177307
CountryCode: US
TelephoneNumber: 6108618080
FaxNumber: 6108070366
Practice Location
Address1: 2775 SCHOENERSVILLE RD
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180177307
CountryCode: US
TelephoneNumber: 6108618080
FaxNumber: 6108070366
Other Information
ProviderEnumerationDate: 08/01/2006
LastUpdateDate: 05/29/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XMD431921PAY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

ID Information
IDTypeStateIssuerDescription
11054501 GEISINGER HEALTH PLANOTHER
729691301 AETNA PPOOTHER
165138901 AETNA HMOOTHER
284935200001 AMERIHEALTHOTHER
5007022901 KEYSTONE HEALTH CENTRALOTHER
196787501PAHIGHMARK BLUE SHIELDOTHER
284935200001 INDEPENDENCE BLUE CROSSOTHER
5007022901 CAPITAL BLUE CROSSOTHER
69532101 HEALTH AMERICA/HEALTH ASSOTHER
P0044763601 RAILROAD MEDICAREOTHER
268502201 UNITED HEALTHCAREOTHER
284935200001 KEYSTONE HEALTH EASTOTHER
912762501 CIGNA HEALTHCAREOTHER


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