Individual
DR. MICHAEL JACOB WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2121
Mailing address
30 N. MARIO CAPECCHI DR., HELIX BUILDING 5050, SALT LAKE CITY, UT 84112
(801) 581-6393
(801) 581-4367
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A92317
CA
Other
Enumeration date
10/01/2007
Last updated
05/16/2024
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