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Individual

BENJAMIN ROBERT WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301502283
MI
207RN0300X
Nephrology Physician
A171392
CA

Other

Enumeration date
06/06/2016
Last updated
06/12/2023
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