Individual
REBECCA WAGNER MICHAELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2301 ERWIN ROAD, DURHAM, NC 27710-1910
(919) 681-2343
Mailing address
1005 W MAIN ST APT 119, DURHAM, NC 27701-3389
(757) 642-3860
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110006278
VA
363AS0400X
Surgical Physician Assistant
Primary
0010-11827
NC
Other
Enumeration date
08/11/2014
Last updated
09/13/2024
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