Michael a Wagner PLLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

5101018806 Issued in MI

Legal business name

MICHAEL A WAGNER PLLC

Practice address

21620 Harrington St
Clinton TWP, MI 48036-2319

Phone

(586) 469-8300

Fax

(586) 469-1372

NPI assigned

Aug 18, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael Wagner, DONPI 1225349665

Title

Owner

Phone

(586) 469-8300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Anthony Wagner, D.O.

  • Orthopaedic Surgery Physician
  • Clinton Township, MI
  • NPI 1225349665
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1992250195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21620 HARRINGTON ST",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480362319",
            "telephone_number": "586-469-8300",
            "fax_number": "586-469-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21620 HARRINGTON ST",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480362319",
            "telephone_number": "586-469-8300",
            "fax_number": "586-469-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A WAGNER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-469-8300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101018806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.