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Individual

DEBORAH C WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM, MSN

Contact information

Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-4380
Mailing address
1560 E. MAPLE RD., SUITE 400-CREDENTIALING, TROY, MI 48083-1138
(248) 581-5970
(248) 581-5640

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
4704118834
MI

Other

Enumeration date
06/07/2006
Last updated
12/08/2015
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