Individual
DR. ELLIOT CHARLES WAGENHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
280 N OLD WOODWARD AVE, SUITE 405, BIRMINGHAM, MI 48009-5300
(248) 642-8330
(248) 642-6630
Mailing address
280 N OLD WOODWARD AVE, SUITE 405, BIRMINGHAM, MI 48009-5300
(248) 642-8330
(248) 642-6630
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
4301035135
MI
2084P0800X
Psychiatry Physician
4301035135
MI
Other
Enumeration date
08/30/2006
Last updated
09/11/2025
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