Individual
DR. MARY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
900 COOPER, SAGINAW, MI 48602
(989) 583-6122
(989) 583-2811
Mailing address
1447 N HARRISON ST, SAGINAW, MI 48602-4727
(989) 583-6122
(989) 583-2811
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301066736
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
930066254
RAIL ROAD MEDICARE
MI
Enumeration date
08/18/2006
Last updated
04/01/2021
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