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Michael Wagner
NPI 1235585191 · on the registry since 2016 · sole proprietor
Practice
- Address
- 170 2nd St S
Nampa, ID 83651 - Phone
- (208) 385-3651
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 225X00000X
225X00000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-05-10
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 Idaho