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Individual

DR. JAMES W. WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 HURLEY PLZ, 7B WEST BLDG, FLINT, MI 48503-5902
(810) 262-9355
(810) 760-9954
Mailing address
18101 OAKWOOD BLVD, TRAUMA SERVICES DEPT, DEARBORN, MI 48123-2500
(313) 982-5440
(313) 982-5445

Taxonomy

Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
4301054569
MI
2086S0127X
Trauma Surgery Physician
4301054569
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0B56029
BLUE SHIELD OF MI
MI
05
4511761
MI
Enumeration date
07/06/2006
Last updated
05/24/2023
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