Organization
ANNAPOLIS BACK & NECK CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES MICHAEL WAGNER D.C. (OWNER)
(410) 267-0033
Entity
Organization
Contact information
Practice address
914 BAY RIDGE RD STE 150, ANNAPOLIS, MD 21403-3953
(410) 267-0033
(410) 267-0444
Mailing address
914 BAY RIDGE RD STE 150, ANNAPOLIS, MD 21403-3953
(410) 267-0033
(410) 267-0444
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
S01457
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M155
BCBS
MD
01
—
W2090001
BCBS FEP
MD
Enumeration date
03/08/2012
Last updated
03/08/2012
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