Wagner, John R

Wagner, John R is an individual health care provider with primary practice located at 11012 E 13 Mile Rd Suite 112, Warren MI 48093-2572. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hand Surgery, which is considered as his primary health care specialty. Wagner, John R can be contacted via phone (586) 573-6880.

Contact Information

Primary practice address
11012 E 13 Mile Rd Suite 112 Warren MI 48093-2572
Phone: (586) 573-6880
Fax: (586) 573-2562
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hand Surgery 207XS0106X 4301061192 Michigan

Profile Details

NPI number 1396737086
LBN Legal business name Wagner, John R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Nov 29th, 2010 - about 15 years 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 1396737086 NPPES
Michigan MEDICAID 4124122
Michigan Other JW061192

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