Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary D Wagner

Individual provider Family Medicine Physician · NPI 1093792822

Mary D Wagner is a Family Medicine Physician in St Louis Park, Minnesota. Licensed in Minnesota. Registered with an NPI since 2005.

Licensed in
MN
In the registry since
2005

Practice location Address checks out

6600 Excelsior Blvd Ste 160
St Louis Park, MN 55426-4744
Phone: (952) 993-7707
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 36748 (MN)

Record details

NPI number1093792822
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 22, 2005
Last updated in NPPESMarch 8, 2012

Other providers in St Louis Park