Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DEBORAH BANAZAK WAGENAAR, D.O.
ActiveDEBORAH BANAZAK WAGENAAR, D.O. is a Geriatric Psychiatry healthcare provider located in EAST LANSING, Michigan. NPI 1255315628 is currently active in the NPPES registry. Verify at CMS.
Geriatric Psychiatry · EAST LANSING, MI
Registration Details
- NPI Number
- 1255315628
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 30, 2005 (20.713740402991 yrs)
- Last Updated
- Jun 29, 2023
- Licenses
-
5101008530 (MI)5101008530 (MI)
Practice Information
- Address
-
909 WILSON RD RM B119EAST LANSING, MI, 488246410Browse MI providers · Browse ZIP 48824
- Phone
- 5173533070
- Fax
- 5178841817
- Primary Specialty
-
Geriatric Psychiatry
2084P0805X
- Additional Specialty
- Geriatric Psychiatry
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.