Individual
MICHAEL DONALD WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
750 NE 13TH ST, STE. 200, OKLAHOMA CITY, OK 73104-5051
(405) 271-4351
Mailing address
940 STANTON L YOUNG BLVD, BMSB 357, OKLAHOMA CITY, OK 73104-5020
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
23008
OK
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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