Individual
JOHN D WAGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1316 E 7TH ST, AUBURN, IN 46706-2523
(260) 925-4600
Mailing address
# 774560, 4560 SOLUTIONS CENTER, CHICAGO, IL 60677-4005
(260) 969-1950
(260) 918-2137
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01040117A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000372545
BC/BS
IN
05
—
100318150A
—
IN
01
—
P00266379
RAILROAD MEDICARE
IN
Enumeration date
12/21/2005
Last updated
02/29/2012
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