Individual
MILES WENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
850 W BARAGA AVE, MARQUETTE, MI 49855-4550
(906) 449-3000
Mailing address
372 LITTLE LAKE RD, MARQUETTE, MI 49855-9256
(314) 296-7319
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704360711
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704360711
MI
Other
Enumeration date
05/26/2020
Last updated
10/03/2022
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