Individual
MATTHEW ANTHONY WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1500 E SHERMAN BLVD, MUSKEGON, MI 49444-1849
(231) 672-2000
Mailing address
PO BOX 776982, CHICAGO, IL 60677-6982
(231) 672-2119
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101027068
MI
208M00000X
Hospitalist Physician
Primary
5101027068
MI
Other
Enumeration date
04/08/2020
Last updated
06/29/2023
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