Individual
MICHAEL V. WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 TRANCAS ST, NAPA, CA 94558-2906
(707) 252-4411
Mailing address
3 HAZELWOOD DR, NAPA, CA 94558-4306
(707) 724-4719
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G52985
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G529850
—
CA
Enumeration date
11/01/2006
Last updated
11/11/2021
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