Individual
MAGDY GEORGE WANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
23600 HARPER AVE, STE 103, ST CLAIR SHORES, MI 48080
(586) 585-2570
(586) 585-2574
Mailing address
23600 HARPER AVE, STE 103, ST CLAIR SHORES, MI 48080
(586) 585-2570
(586) 585-2574
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MW065519
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1105007952
BCBS
—
01
—
127679
CARE CHOICES
—
05
—
4243830
—
MI
01
—
7189170
AETNA
—
05
—
912517500
—
FL
01
—
C7549
MCARE
—
01
—
G89641
HAP
—
01
—
P00051536
MEDICARE RR
—
01
—
P105025
BCN
—
Enumeration date
08/16/2006
Last updated
07/08/2007
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