Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL D WAGNER
Active Sole ProprietorMICHAEL D WAGNER is a Assisted Living Facility healthcare provider located in GRAND RAPIDS, Michigan. NPI 1336655034 is currently active in the NPPES registry. Verify at CMS.
Assisted Living Facility · GRAND RAPIDS, MI
Registration Details
- NPI Number
- 1336655034
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 18, 2017 (8.4692021885449 yrs)
- Last Updated
- Dec 18, 2017
- License
-
AF410387497 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
807 PINE AVE NWGRAND RAPIDS, MI, 495044340Browse MI providers · Browse ZIP 49504
- Phone
- 6167767094
- Fax
- 6167767094
- Primary Specialty
-
Assisted Living Facility
311ZA0620X
Other Assisted Living Facility Providers in GRAND RAPIDS, MI
| Name | Credential | NPI |
|---|---|---|
| CYNTHIA BUSHNELL | — | 1447781984 |
| NATHAN BIESZKA | — | 1548796576 |
| TENAGNE MENGISTU | — | 1801324538 |
| EBRIMA DRAMMEH | — | 1558949206 |
| MARITZA WOLF | — | 1508711177 |
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.