Search › Michigan › 1835P1200X
Diane Wagner
NPI 1235540402 · on the registry since 2014
Practice
- Address
- 4963 John R Rd
Troy, MI 48085 - Phone
- (248) 689-2157
- Fax
- (248) 740-5940
- Organisation at this address
- Woodward Detroit Cvs, L.L.C.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 1835P1200X
1835P1200X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2014-05-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan