Individual
DR. DEANNA MARIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 HEALTH PARK DR, OWOSSO, MI 48867-1291
(989) 723-6666
Mailing address
200 HEALTH PARK DR, OWOSSO, MI 48867-1291
(989) 723-6666
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301102748
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104141654
—
MI
Enumeration date
03/27/2010
Last updated
04/18/2022
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