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

Nicholas Brennan Wagner, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1003583642

Nicholas Brennan Wagner, MD is a Diagnostic Radiology in Tampa, Florida. Graduated from Mercer University School of Medicine in 2022, 4 years ago. Works from 2 locations.

Years since qualifying
4
Trained at
Mercer University School of Medicine
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone: (813) 974-2201
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1550 College St, Macon, GA 31207-1500 — (478) 301-2600

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1003583642
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 23, 2021
Last updated in NPPESMay 3, 2022
Certification dateMay 3, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolMERCER UNIVERSITY SCHOOL OF MEDICINE
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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