MATTHEW ANTHONY WAGNER (NPI# 1700415965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700415965 |
| Entity Type | Individual |
| Full Name | MATTHEW ANTHONY WAGNER |
| Credential | DO |
| Practice Address |
1500 E Sherman Blvd Muskegon MI 49444-1849 |
| Mailing Address |
1675 Leahy St Ste 315a Muskegon MI 49442-5543 |
| Practice Telephone | 2316722000 |
| Mailing Telephone | 2317275247 |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2020-04-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578052866 | Matthew Robert Wagner | Dentist | 2830 Curry Ln #1, Green Bay, WI 54311 | 2018-05-02 |
| 1538534334 | Matthew Wagner | Acupuncturist | 4513 Vernon Blvd, Madison, WI 53705-4993 | 2015-12-04 |
| 1053749168 | Matthew Wagner | Counselor | 545 N Mcdonough St Ste 212, Decatur, GA 30030-3310 | 2013-10-29 |
| 1114198751 | Matthew Robert Wagner | Orthopaedic Surgery | 1500 Route 112 Bldg 2c, Port Jefferson Station, NY 11776-8055 | 2008-03-21 |
| 1376177048 | Matthew Gary Wagner | Case Manager/Care Coordinator | 16 W Long St, Columbus, OH 43215-2815 | 2020-03-02 |
| 1235613738 | Matthew James Wagner | Pharmacist | 17213 Cole Rd, Hagerstown, MD 21740-6981 | 2018-09-20 |
| 1164918199 | Matthew Steven Wagner | Internal Medicine | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2018-07-02 |
| 1609371244 | Matthew Anthony Wagner | Student in an Organized Health Care Education/Training Program | 509 Biltmore Ave, Asheville, NC 28801-4601 | 2018-03-26 |
| 1669994752 | Matthew Wagner | Behavior Technician | 415 Medical Dr Ste D101, Bountiful, UT 84010-8905 | 2017-07-11 |
| 1174973432 | Matthew Wagner | Peer Specialist | 190 Match Factory Pl, Bellefonte, PA 16823-1367 | 2016-06-17 |
| Street Address |
1500 E SHERMAN BLVD |
| City | MUSKEGON |
| State | MI |
| Zip Code | 49444-1849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740282904 | James J Bleicher | Internal Medicine | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2005-06-01 |
| 1154934842 | Nicklas Lee Raycraft | Nurse Practitioner | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-08-24 |
| 1447860499 | Michael Edward Curran | Pharmacist | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-08-05 |
| 1669098810 | Keith Abraham | Registered Nurse | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-06-24 |
| 1689299018 | Baldwin Family Health Care | Dentist | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-06-11 |
| 1740804616 | Tanner Thomas Hecht | Physician Assistant | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-06-05 |
| 1770112930 | Luis M Rodriguez-galliano | Student in an Organized Health Care Education/Training Program | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-04-08 |
| 1487283628 | Kristen D Bruce | Student in an Organized Health Care Education/Training Program | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-04-08 |
| 1003445263 | Kyle Nathaniel Turcic | Student in an Organized Health Care Education/Training Program | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-04-08 |
| 1538708227 | Austin Vanree | Physician Assistant | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2019-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073084349 | Cathy Forrest, Ma, LLP Plc | Psychologist | 255 Seminole Road, Suite-205, Muskegon, MI 49444 | 2018-12-16 |
| 1831687276 | Sarah J Weiden | Massage Therapist | 1040 E Sternberg Rd, Muskegon, MI 49444 | 2018-04-30 |
| 1184131500 | Hatem M Gelani Sr. | Dentist | 1725 E Sherman Blvd, Muskegon, MI 49444 | 2018-01-08 |
| 1497123673 | Rite Aid | Pharmacist | 2213 E Hile Road, Muskegon, MI 49444 | 2015-09-04 |
| 1689077075 | Rosa Carpenter-parker | Counselor | 445 East Sherman, Muskegon, MI 49444 | 2014-09-30 |
| 1417373036 | Smile Center Pllc | Dentist | 3500 Park Street, Smile Center Pllc, Muskegon, MI 49444 | 2014-03-06 |
| 1134460439 | Adam L Powell | Physical Medicine & Rehabilitation | 1675 E Mount Garfield Rd, Muskegon, MI 49444 | 2013-03-12 |
| 1972847135 | Kristen Haugh | Physical Therapist | 5251 Harvey St Ste 100, Norton Shores, MI 49444 | 2012-11-12 |
| 1912261694 | Brandon D Freel | Obstetrics & Gynecology | 6401 Prairie St Ste 2100, Norton Shores, MI 49444 | 2012-06-27 |
| 1437434487 | Amy Stegall | Pharmacist | 1171 E Sherman, Norton Shores, MI 49444 | 2011-10-20 |
| Find all providers in zip 49444 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538797105 | Laurie Anne Smith | Student in an Organized Health Care Education/Training Program | 1675 Leahy St Ste 200b, Muskegon, MI 49442-5542 | 2020-03-30 |
| 1265069132 | John Whitney Rajala | Student in an Organized Health Care Education/Training Program | 1675 Leahy St Ste 201, Muskegon, MI 49442-5542 | 2020-03-23 |
| 1447735915 | Melanie Praay | Student in an Organized Health Care Education/Training Program | 3090 Bonneta Rd, Muskegon, MI 49442-1501 | 2018-10-01 |
| 1831584705 | Benjamin Wheeler | Student in an Organized Health Care Education/Training Program | 2450 E Bard Rd, Muskegon, MI 49445-9542 | 2015-03-30 |
| 1144453267 | Susan S Lee | Student in an Organized Health Care Education/Training Program | 1700 Oak Ave Ste 7, Muskegon, MI 49442-2407 | 2009-08-25 |
| 1164044830 | Justin R Staley | Student in an Organized Health Care Education/Training Program | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-05-15 |
| 1770112930 | Luis M Rodriguez-galliano | Student in an Organized Health Care Education/Training Program | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-04-08 |
| 1487283628 | Kristen D Bruce | Student in an Organized Health Care Education/Training Program | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-04-08 |
| 1184253312 | Bernadette Mcdermott Dazzo | Student in an Organized Health Care Education/Training Program | 1700 Clinton St, Muskegon, MI 49442-5502 | 2020-04-08 |
| 1003445263 | Kyle Nathaniel Turcic | Student in an Organized Health Care Education/Training Program | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2020-04-08 |
| Find all providers in MUSKEGON | ||||
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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.