IndividualActive
Michael Wagner, MD
NPI 1043217797 · Pulmonary Disease Physician · Espanola, NM
Provider details
- NPI number
- 1043217797
- Entity type
- Individual
- Primary specialty
- Pulmonary Disease PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 81335 (NM)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1010 Spruce St 3rd Fl Area 5
Espanola, NM 87532-2724
Phone: (505) 367-0340
Fax: (505) 747-2025
Approximate (ZIP-level) locationGet directions
Mailing address
835 Spruce St Ste B
Espanola, NM 87532-3455
Registry dates
- Enumerated
- 2005-07-07
- Last updated
- 2024-04-11
- Certified
- 2024-04-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.