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Search › Georgia › 363A00000X

Heather Wagner

NPI 1336903319 · on the registry since 2024 · sole proprietor

Practice

Address
470 Northside Cherokee Blvd Ste 201
Canton, GA 30115
Phone
(770) 720-7246
Fax
(770) 720-4620
Organisation at this address
Georgia Urology Pa
Georgia Urology Pa
Georgia Urology, Pa
Inferred from a shared address, not stated in the registry.
Clinicians at this address
47

Registry record

Primary taxonomy
363A00000X
363A00000X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-05-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia