Individual
DR. CHRISTOPHER CHARLES WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
71 BEVIER ST, SHELBY, MI 49455-1209
(231) 861-2187
(231) 861-5100
Mailing address
PO BOX 1848, MUSKEGON, MI 49443-1848
(231) 672-2119
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101025520
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982134482
—
MI
Enumeration date
06/16/2017
Last updated
12/10/2021
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