Wagner, Michel Randolph Peter

Wagner, Michel Randolph Peter is an individual health care provider with primary practice located at 2580 Haymaker Rd Ste 304 , Monroeville PA 15146-3500. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgical Critical Care is his primary health care specialty. Wagner, Michel Randolph Peter can be contacted via phone (412) 858-3070.

Contact Information

Primary practice address
2580 Haymaker Rd Ste 304 Monroeville PA 15146-3500
Phone: (412) 858-3070
Fax: (412) 858-3076
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD066014L Pennsylvania
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X MD066014L Pennsylvania
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X MD066014L Pennsylvania

Profile Details

NPI number 1447200647
LBN Legal business name Wagner, Michel Randolph Peter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2006
Last updated Oct 6th, 2020 - about 5 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 1447200647 NPPES
Other 10614208 CAQH

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