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Paul Michael Wagner
Family Nurse Practitioner in Sanford, Michigan
NPI 1043919996

Paul Michael Wagner is a Family Nurse Practitioner based in Sanford, MI and is specialized in Family. Paul Michael Wagner practices in Sanford, MI. The NPI Number for Paul Michael Wagner is 1043919996 and holds a License No. 4704345086 (Michigan).

The current practice location address for Paul Michael Wagner is 515 W Lynthur Ln, Sanford, MI and can be reached out via phone at 989-488-7835.

Location: 515 W Lynthur Ln, Sanford, MI, 48657-9318
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043919996
Provider Name
Paul Michael Wagner
Credential
Provider Entity Type
Individual
Gender
Male
Address
515 W Lynthur Ln, Sanford, MI, 48657-9318
Phone Number
989-488-7835
Fax Number
Provider Enumeration Date
03/01/2023
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4704345086 05 MI
institution
Provider Business Practice Location Address Details
Address
515 W Lynthur Ln
City
Sanford
State
Michigan
Zip
48657-9318
Phone Number
989-488-7835
Fax Number
person
Provider Business Mailing Address Details
Address
515 W Lynthur Ln
City
Sanford
State
Michigan
Zip
48657-9318
Phone Number
989-488-7835
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
4704345086 (Michigan)
Definition
Definition to come...
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