| Michael D Wagner, MD | |
|
1010 Spruce St 3rd Fl Area 5, Espanola, NM 87532-2724 | |
| (505) 367-0340 | |
| (505) 747-2025 |
| Full Name | Michael D Wagner |
|---|---|
| Gender | Male |
| Speciality | Pulmonary Disease |
| Experience | 47 Years |
| Location | 1010 Spruce St 3rd Fl Area 5, Espanola, New Mexico |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043217797 | NPI | - | NPPES |
| 33308 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 81335 (New Mexico) | Secondary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | 81-335 (New Mexico) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Presbyterian Espanola Hospital | Espanola, NM | Hospital |
| Holy Cross Hospital A Div Of Taos Health Systems | Taos, NM | Hospital |
| Presbyterian Hospital | Albuquerque, NM | Hospital |
| Christus St Vincent Regional Medical Center | Santa fe, NM | Hospital |
| Los Alamos Medical Center | Los alamos, NM | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Presbyterian Healthcare Services | 9234041708 | 1179 |
| Entity Name | Presbyterian Healthcare Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104802354 PECOS PAC ID: 9234041708 Enrollment ID: O20031103000603 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael D Wagner, MD 835 Spruce St Ste B, Espanola, NM 87532-3455 Ph: (505) 753-7499 | Michael D Wagner, MD 1010 Spruce St 3rd Fl Area 5, Espanola, NM 87532-2724 Ph: (505) 367-0340 |
Rajan K Mirchandani, MD Pulmonary Disease Medicare: Not Enrolled in Medicare Practice Location: 1010 Spruce St, Espanola Hospital Pmg Clinic, Espanola, NM 87532 Phone: 505-367-0340 Fax: 505-367-4470 | |
William M Ryan, MD Pulmonary Disease Medicare: Not Enrolled in Medicare Practice Location: 1010 Spruce St, Espanola Hospital, Espanola, NM 87532 Phone: 505-367-0340 Fax: 505-367-0346 | |
Salvadeeswaran Lakshmi-narayanan, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 1010 Spruce St, Espanola, NM 87532 Phone: 505-367-0340 Fax: 505-367-0346 | |
Melissa Diane Sugar, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 1010 Spruce Street, Hospitalist-espanola, Espanola, NM 87532 Phone: 505-753-7111 Fax: 053-670-2885 | |
Jorge A Aguilar, MD Pulmonary Disease Medicare: Not Enrolled in Medicare Practice Location: 1010 Spruce St, Espanola Hospital, Espanola, NM 87532 Phone: 505-753-7111 Fax: 505-753-4438 | |
Kalu B Long, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 1010 Spruce St, Espanola, NM 87532 Phone: 505-753-7111 |