IndividualActive
Karl Wagner, PA-C
NPI 1720179500 · Physician Assistant · Southfield, MI
Provider details
- NPI number
- 1720179500
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 5601001954 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
22255 Greenfield Rd
Suite 422
Southfield, MI 48075-3710
Phone: (248) 849-3195
Fax: (248) 849-3390
Street-level locationGet directions
Mailing address
57813 Cider Mill Dr
New Hudson, MI 48165-9482
Registry dates
- Enumerated
- 2006-09-27
- Last updated
- 2009-12-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.