Aaron Van Wagnen MD PLLC
Organization Active NPI Internal Medicine Physician · Jackson, MI
NPI 1013145846 · NPPES record last updated Jul 1, 2009
Key facts
- NPI
- 1013145846
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 078023 (MI)
- Legal business name
- AARON VAN WAGNEN MD PLLC
- Practice address
- 1310 Greenwood Ave
Jackson, MI 49203-3077 - Phone
- (517) 787-1990
- Fax
- (517) 787-9183
- NPI assigned
- Jul 1, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Aaron Michael Van Wagnen, MD
- Title
- Physician
- Phone
- (517) 787-1990
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 078023 | MI | Yes |
Addresses
Primary practice location
1310 Greenwood Ave
Jackson, MI 49203-3077
Mailing address
1310 Greenwood Ave
Jackson, MI 49203-3077
Phone (517) 787-1990
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4669435 | Medicaid | MI |
Other providers in Jackson, MI
- A Fagan Counseling Services LLC
- A Healing Place, LLC
- A.R.E. Inc., of Jackson
- Syeda Abeera Aalamin
- Aaron M Vanwagnen MD PLLC
- Chidinma Jennifer Abara
- Mohammad Abbas
- Jon Filip Abbey
- Tracey L Abbey
- Jenna Abbott
All providers in Jackson, MI · Internal Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.