Individual
MICHAEL WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
286924
NY
208M00000X
Hospitalist Physician
Primary
286924
NY
Other
Enumeration date
04/05/2015
Last updated
09/30/2021
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