Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ELLIOT CHARLES WAGENHEIM, M.D.
Active Sole ProprietorDR. ELLIOT CHARLES WAGENHEIM, M.D. is a Forensic Psychiatry healthcare provider located in BIRMINGHAM, Michigan. NPI 1588774566 is currently active in the NPPES registry. Verify at CMS.
Forensic Psychiatry · BIRMINGHAM, MI
Registration Details
- NPI Number
- 1588774566
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 30, 2006 (19.925648249456 yrs)
- Last Updated
- Sep 11, 2025
- Licenses
-
4301035135 (MI)4301035135 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
280 N OLD WOODWARD AVESUITE 405BIRMINGHAM, MI, 480095300Browse MI providers · Browse ZIP 48009
- Phone
- 2486428330
- Fax
- 2486426630
- Primary Specialty
-
Forensic Psychiatry
2084F0202X
- Additional Specialty
- 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.