Individual
DR. JOHN C WAGONLANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8383 W ALAMEDA AVE, LAKEWOOD, CO 80226-3007
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
054246
CO
207R00000X
Internal Medicine Physician
48544
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025040
KAISER COMMERCIAL NUMBER
CO
05
—
617417500
—
MN
05
—
77685016
—
CO
Enumeration date
08/04/2006
Last updated
05/20/2021
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