Cervin -Wagner, Michelle I

Cervin -Wagner, Michelle I is an individual health care provider with primary practice located at 601 E Chicago Rd , White Pigeon MI 49099-9731. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Cervin -Wagner, Michelle I can be contacted via phone (269) 483-7624.

Contact Information

Primary practice address
601 E Chicago Rd White Pigeon MI 49099-9731
Fax: (269) 483-7905
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101011099 Michigan
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02001685 Indiana

Profile Details

NPI number 1891711362
LBN Legal business name Cervin -Wagner, Michelle I
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2006
Last updated Jan 4th, 2024 - about 11 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891711362 NPPES
Michigan MEDICAID 1891711362

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