DIANE WAGNER (NPI# 1235540402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235540402 |
| Entity Type | Individual |
| Full Name | DIANE WAGNER |
| Practice Address |
4963 John R Rd Troy MI 48085-3572 |
| Practice Telephone | 2486892157 |
| Practice Fax Number | 2487405940 |
| Mailing Telephone | 2486892157 |
| Mailing Fax Number | 2487405940 |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2014-05-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
5302022570 | MI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104159615 | Diane Marie Wagner | Specialist | 364 Division St, Park Falls, WI 54552-1258 | 2009-09-15 |
| 1194812164 | Diane Wagner | Pathology | 43 Shebar Dr, Islip, NY 11751-4409 | 2006-10-09 |
| 1194211540 | Diane Wagner | Psychologist | 11130 Fairfax Blvd Ste 305, Fairfax, VA 22030-5035 | 2018-07-09 |
| 1366998528 | Diane Marie Wagner | Counselor | 4701 Van Dorn St, Lincoln, NE 68506-2562 | 2016-08-28 |
| 1083777148 | Diane Wagner | Social Worker | 5100 2nd St Nw, Albuquerque, NM 87107-4009 | 2006-12-19 |
| 1770502338 | Diane Marie Wagner | Social Worker | 1601 Sw Archer Rd, Gainesville, FL 32608 | 2006-07-18 |
| 1336180900 | Diane Brown Wagner | Radiology | 1453 E Bert Kouns Loop, Radiology, Shreveport, LA 71105-6800 | 2006-06-08 |
| Street Address |
4963 JOHN R RD |
| City | TROY |
| State | MI |
| Zip Code | 48085-3572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588776454 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 4963 John R Rd, Troy, MI 48085-3572 | 2006-08-31 |
| 1497386528 | Joyce Agnes Johnson | Pharmacist | 4963 John R Rd, Troy, MI 48085-3572 | 2020-01-28 |
| 1275164386 | Dalya K Al-rawi | Pharmacist | 4963 John R Rd, Troy, MI 48085-3572 | 2020-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790327252 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd #120, Suite 120, Troy, MI 48085 | 2019-10-16 |
| 1538712948 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd, Suite 120, Troy, MI 48085 | 2019-07-24 |
| 1669035093 | William Beaumont Hospital | Pharmacy | Beaumont Hospital Troy, 44201 Dequindre, Room 11a0310, Troy, MI 48085 | 2019-04-22 |
| 1487126926 | Long Lake Rx | Pharmacy | 2888 E Long Lake Rd Suite 120, Troy, MI 48085 | 2018-12-21 |
| 1295226579 | Jeffrey Paul Biehl | Nurse Anesthetist, Certified Registered | 44249 Dequindre Rd., Troy, MI 48085 | 2018-05-23 |
| 1619478666 | Trisha Misiewicz | Physical Therapist | 42201 Dequindre Rd, Troy, MI 48085 | 2018-02-26 |
| 1760900393 | Sensory Rehabilitation LLC | Physical Therapist | 4413, Reilly Ct, Troy, MI 48085 | 2017-09-04 |
| 1841710837 | James L Chang | Dentist | 1883 E Wattles, Troy, MI 48085 | 2017-06-21 |
| 1033567953 | Brittany N David | Physician Assistant | 2041 E Square Lake Rd Suite 300, Troy, MI 48085 | 2016-06-01 |
| 1053784199 | Brianna Lynn Manica | Nurse Practitioner | 44201 Dequindre Rd., Ste. 400 Troy Beaumont Hospital, Troy, MI 48085 | 2015-11-12 |
| Find all providers in zip 48085 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689003337 | Benjamin Leo Grilliot | Pharmacist | 233 Grant St, Troy, OH 45373-3117 | 2013-11-04 |
| 1194871061 | Louis A Zawaideh | Pharmacist | 1179 Maplelawn Dr, Troy, MI 48084-5515 | 2007-01-25 |
| 1164815825 | Umang Desai | Pharmacist | 735 John R Rd, Suite 150, Troy, MI 48083-5856 | 2015-03-05 |
| 1255742318 | Ronald Poling | Pharmacist | 1900 W Main St, Troy, OH 45373-1017 | 2014-05-12 |
| 1598175135 | Katherine Lewnau | Pharmacist | 735 John R Rd, Suite 150, Troy, MI 48083-5856 | 2014-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477184125 | Lillian Atty | Pharmacist | 1484 Rivona Dr, Waterford, MI 48328 | 2020-01-31 |
| 1598249492 | Kayvon Anthony Parvizi | Pharmacist | G-2333 Center Rd, Burton, MI 48519 | 2018-09-18 |
| 1376039826 | Alexander J Hessler I | Pharmacist | 5121 S Westnedge Ave., Kalamazoo, MI 49008 | 2018-07-09 |
| 1407396831 | Michael Keller | Pharmacist | 6329 Red Rock Ct, Norton Shores, MI 49444-8794 | 2017-03-04 |
| 1366846024 | John Nguyen | Pharmacist | 747 E 16th St, Holland, MI 49423 | 2014-10-09 |
| 1720494529 | Shelby Chopp | Pharmacist | 64670 Windrose Way, Lawton, MI 49065-9238 | 2014-07-01 |
| 1124431879 | Ann E Ziel | Pharmacist | 2799 10 Mile Rd Ne # Rde, Rockford, MI 49341-9100 | 2014-06-10 |
| 1316350887 | Jeffrey John Wieczorek | Pharmacist | 9416 Wildwood Lake Dr, Whitmore Lake, MI 48189-9430 | 2014-06-03 |
| 1467863993 | Tom Zoyiopoulos | Pharmacist | 1201 Lears, Indian River, MI 49749 | 2014-05-19 |
| 1063823698 | Waqas Akhtar | Pharmacist | 316 N Drake Rd, Kalamazoo, MI 49009-1106 | 2014-05-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.