JOHN R WAGNER JR. (NPI# 1396737086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396737086 |
| Entity Type | Individual |
| Full Name | JOHN R WAGNER JR. |
| Credential | M.D. |
| Practice Address |
11012 E 13 Mile Rd Suite 112 Warren MI 48093-2572 |
| Mailing Address |
29900 Lorraine Ave Suite 400 Warren MI 48093-5266 |
| Practice Telephone | 5865736880 |
| Practice Fax Number | 5865732562 |
| Mailing Telephone | 5865820864 |
| Mailing Fax Number | 5865820964 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2010-11-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
4301061192 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4124122 | 05 | |
| MI | BCBS PIN # | JW061192 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861802498 | John M. Wagner | Counselor | 1048 Sumac St, Longmont, CO 80501-4146 | 2014-05-05 |
| 1326323221 | John Wagner | Physical Therapist | 3079 Nestall Rd, Laguna Beach, CA 92651-2026 | 2011-10-12 |
| 1821384728 | John C Wagner | Pharmacist | 1703 Elm St W, Hampton, SC 29924 | 2011-06-20 |
| 1033320577 | John Wagner | Psychiatry & Neurology | 7330 Fern Ave Ste 704, Shreveport, LA 71105-4985 | 2007-05-25 |
| 1013044197 | John Daniel Wagner | Massage Therapist | 2315 N Pearl St Ste 10, Pmb 188, Tacoma, WA 98406-2553 | 2007-02-27 |
| 1588719066 | John J Wagner | Psychologist | 7374 Reading Rd Ste 110, Cincinnati, OH 45237-3409 | 2007-01-24 |
| 1033262340 | John D Wagner | Internal Medicine | 451 Clarkson Ave Rm B-1147, Kings County Hospital Center, Brooklyn, NY 11203-2054 | 2007-01-19 |
| 1942316385 | John Otto Wagner | Legal Medicine | 1950 Stanley Rd Bldg 2376, San Antonio Military Entrance Processing Station, Fort Sam Houston, TX 78234-7547 | 2006-08-21 |
| 1881635159 | John Adam Wagner | Chiropractor | 411 Hyde Park, Doylestown, PA 18902-6619 | 2006-06-09 |
| 1386697019 | John Wagner | Specialist/Technologist | 35 Colgate St, Jersey City, NJ 07302-3307 | 2006-05-17 |
| Street Address |
11012 E 13 MILE RD SUITE 112 |
| City | WARREN |
| State | MI |
| Zip Code | 48093-2572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801896519 | Edward F Burke | Orthopaedic Surgery | 11012 E 13 Mile Rd, Suite 112, Warren, MI 48093-2572 | 2005-07-22 |
| 1184086118 | Elizabeth Cogswell | Orthotist | 11012 E 13 Mile Rd, Ste 210, Warren, MI 48093-2572 | 2016-03-29 |
| 1013376763 | Kamila Anna Malinowska | Obstetrics & Gynecology | 11012 E 13 Mile Rd, Warren, MI 48093-2572 | 2016-02-22 |
| 1760856629 | Sairah Safdar | Occupational Therapist | 11012 E 13 Mile Rd, Suite 200, Warren, MI 48093-2572 | 2015-11-16 |
| 1710322045 | Amy Katherine Doepker | Physical Therapist | 11012 E 13 Mile Rd, Suite 200, Warren, MI 48093-2572 | 2013-04-30 |
| 1639420458 | Caitlin N Lukasik | Occupational Therapist | 11012 E 13 Mile Rd, Ste. 200, Warren, MI 48093-2572 | 2012-09-20 |
| 1437450020 | Francine Ivey | Physical Therapist | 11012 E 13 Mile Rd, Suite 200, Warren, MI 48093-2572 | 2010-11-12 |
| 1851539498 | Southfield Rehabilitation Company | General Acute Care Hospital | 11012 E 13 Mile Rd, Suite 111, Warren, MI 48093-2572 | 2009-02-04 |
| 1528206562 | Southfield Rehabilition Company | Clinic/Center | 11012 E 13 Mile Rd, Suite 112a, Warren, MI 48093-2572 | 2009-01-29 |
| 1245480581 | Zena G Yousif | Surgery | 11012 E 13 Mile Rd, Suite 112, Warren, MI 48093-2572 | 2008-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
| 1679112676 | Open Heart Communities | Case Management | 31310 Shaw Dr, Warren, MI 48093 | 2019-12-23 |
| 1538715636 | 3 Dove Medical Supplies | Durable Medical Equipment & Medical Supplies | 31201 Chicago Rd S Ste C101, Warren, MI 48093 | 2019-08-14 |
| 1568954600 | Schreiber Cardiology, P.C. | Internal Medicine | 8545 Common Rd Ste 150, Warren, MI 48093 | 2018-06-05 |
| 1730686197 | Lambro Seremetis | Social Worker | 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 | 2018-04-11 |
| 1649775826 | Ridge Downs | Behavioral Analyst | 31201 Chicago Rd South, Suite C- 202, Warren, MI 48093 | 2018-03-28 |
| 1144722737 | Jessica Farraj | Occupational Therapist | 11800 E. 12 Mile Road, Warren, MI 48093 | 2018-02-28 |
| 1265930168 | Leah Hanrahan | Registered Nurse | 11700 Amberle Dr., Warren, MI 48093 | 2018-01-25 |
| 1598271553 | Pamela Marie Confer | Occupational Therapist | 11012 13 Mile Rd, Suite 200, Warren, MI 48093 | 2017-12-28 |
| 1831604347 | Kate Jeanne Szczepanski | Behavior Technician | 31200 Chicago Rd S, Warren, MI 48093 | 2017-12-06 |
| Find all providers in zip 48093 | ||||
| Taxonomy Code | 207XS0106X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Hand Surgery |
| An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164408985 | Steven Alan Kushner | Orthopaedic Surgery | 3272 E 12 Mile Rd Ste 106, Deerfield Meadows, Warren, MI 48092-5622 | 2005-12-22 |
| 1801896519 | Edward F Burke | Orthopaedic Surgery | 11012 E 13 Mile Rd, Suite 112, Warren, MI 48093-2572 | 2005-07-22 |
| 1538151436 | Guy Pierret | Orthopaedic Surgery | 11012 E 13 Mile Rd, Suite 112, Warren, MI 48093-2572 | 2005-08-17 |
| 1245230036 | Robert S Barbosa | Orthopaedic Surgery | 11012 E 13 Mile Rd, Suite 112, Warren, MI 48093-2572 | 2005-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861736027 | Scott Sami Samona | Orthopaedic Surgery | 22731 Newman St Ste 100a, Dearborn, MI 48124-2031 | 2012-11-12 |
| 1720216187 | William R. Truluck II Do Pllc | Orthopaedic Surgery | 3945 Okemos Rd Ste B4, Okemos, MI 48864 | 2009-06-24 |
| 1215101290 | Ruth Marie Baer | Orthopaedic Surgery | 965 Fee Rd, East Fee Hall, Room A233, East Lansing, MI 48824-6569 | 2008-04-21 |
| 1962617639 | William Ray Truluck | Orthopaedic Surgery | 1841 Newman Rd, Suite, Okemos, MI 48864-1122 | 2007-05-14 |
| 1710102389 | Uzma Rehman Do PC | Orthopaedic Surgery | 45650 Schoenherr Rd, Suite A, Shelby Township, MI 48315-6033 | 2007-04-17 |
| 1386651487 | B Kent Maupin Md PC | Orthopaedic Surgery | 1001 Medical Park Dr Se, Suite 211, Grand Rapids, MI 49546-3610 | 2006-08-02 |
| 1033140959 | Frederick Victor Minkow | Orthopaedic Surgery | 43700 Woodward Avenue, Suite 205, Bloomfield Hills, MI 48302-0561 | 2006-07-06 |
| 1245261007 | Stephen Edward Werner | Orthopaedic Surgery | 1349 S Rochester Rd Ste 225, Rochester Hills, MI 48307-3183 | 2006-07-06 |
| 1801839816 | David L Gerstner | Orthopaedic Surgery | 601 John St Ste M-206c, Kalamazoo, MI 49007-5359 | 2006-06-14 |
| 1730120361 | John Michael Trupiano | Orthopaedic Surgery | 201 W Big Beaver Rd Ste 1140, Troy, MI 48084-4160 | 2006-06-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JOHN R WAGNER JR..
| 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.