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Jordan M Wagner, PA
Family Medicine Physician in Niles, Michigan
NPI 1831383074

Jordan M Wagner is a Family Medicine Physician based in Berrien Center, MI. Jordan M Wagner practices in Niles, MI and has the professional credentials of PA. The NPI Number for Jordan M Wagner is 1831383074 and holds a License No. 5601005116 (Michigan).

The current practice location address for Jordan M Wagner is 2002 S 11Th St, Niles, MI and can be reached out via phone at 269-687-0200 and via fax at 269-684-0199.

Location: 2002 S 11Th St, Niles, MI, 49102-9750
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1831383074
Provider Name
Jordan M Wagner
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
2002 S 11Th St, Niles, MI, 49102-9750
Phone Number
269-687-0200
Fax Number
269-684-0199
Provider Enumeration Date
08/30/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1831383074 05 MI
institution
Provider Business Practice Location Address Details
Address
2002 S 11Th St
City
Niles
State
Michigan
Zip
49120-4074
Phone Number
269-687-0200
Fax Number
269-684-0199
person
Provider Business Mailing Address Details
Address
2002 S 11Th St
City
Niles
State
Michigan
Zip
49120-4074
Phone Number
269-687-0200
Fax Number
269-684-0199
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
5601005116 (Michigan)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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