Individual
ANDREW STANDISH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 CAMPUS RIDGE DR STE LL110, MIDLAND, MI 48640-6126
(989) 837-9400
(989) 792-9860
Mailing address
5400 MACKINAW RD, SUITE 6100, SAGINAW, MI 48604-9515
(989) 792-3100
(989) 792-9860
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301076172
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10 4203718
—
MI
01
—
P105248
BLUE CARE NETWORK ID #
—
Enumeration date
01/04/2006
Last updated
11/05/2024
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