DR. GREGORY ALAN WAGONER M.D.
NPI 1700965324
Internal Medicine in Boston, MA

Q: What is Gregory Wagoner's NPI number?

The NPI number for Gregory Wagoner is 1700965324. It was assigned to this individual provider in the NPPES registry on November 3, 2006.

Q: What is Gregory Wagoner's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Gregory Wagoner was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 03, 2006

729 MASSACHUSETTS AVE, BOSTON, MA 02118(617) 414-7779(617) 414-7776 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Gregory Alan Wagoner M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GREGORY ALAN WAGONER M.D. (NPI 1700965324) is an individual internal medicine provider in Boston, Massachusetts, licensed in Massachusetts (38544) and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1700965324

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. GREGORY ALAN WAGONERCredential: M.D.

Location Address729 MASSACHUSETTS AVEBoston, MA 02118-2318

Mailing Address119 Commonwealth AveChestnut Hill, MA 02467-1004 · (617) 964-5754 · Fax (617) 414-7776

Phone(617) 414-7779

Fax(617) 414-7776

Sole ProprietorNo

Enumeration DateNovember 3, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1700965324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MA · 38544

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

729 MASSACHUSETTS AVE, Boston, MA 02118

Open in Google Maps ↗

Other Identifiers 2

Medicare UPINB72990MA

Medicare ID-Type UnspecifiedB33492MA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIE A TELLUS R.N.

Registered Nurse