| Erik W Wagner, FNP | |
| 4838 E. Baseline Rd., Bldg 2, Suite 109, Mesa, AZ 85206-4677 | |
| (480) 969-4040 | |
| (480) 830-1042 | 
| Full Name | Erik W Wagner | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Practitioner - Family | 
| Location | 4838 E. Baseline Rd., Mesa, Arizona | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1033129150 | NPI | - | NPPES | 
| Z233314 | Other | AZ | MEDICARE PTAN | 
| 825839 | Medicaid | AZ | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | TAP4826 (Arizona) | Secondary | 
| 363LF0000X | Nurse Practitioner - Family | AP4826 (Arizona) | Primary | 
| Entity Name | George Wang,md,llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1184679201 PECOS PAC ID: 6608789755 Enrollment ID: O20031106000242 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Erik W Wagner, FNP 4824 E Baseline Rd, Suite 110, Mesa, AZ 85206-4676 Ph: (480) 969-4040 | Erik W Wagner, FNP 4838 E. Baseline Rd., Bldg 2, Suite 109, Mesa, AZ 85206-4677 Ph: (480) 969-4040 | 
| Aida E Amado, MS, ACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10163 E Jacob Ave, Mesa, AZ 85209 Phone: 480-296-8849 | |
| Marilyn Rose Schatz, ACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6750 E Baywood Ave, Suite 401, Mesa, AZ 85206 Phone: 480-835-7111 Fax: 480-969-9345 | |
| Mrs. Krista Ann Roppelt, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3155 E Southern Ave Ste 203, Mesa, AZ 85204 Phone: 480-325-8173 Fax: 480-325-8179 | |
| Jennifer Christine Fendler, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 924 N Country Club Dr, Mesa, AZ 85201 Phone: 480-601-3528 | |
| Alisha Kristine Holben, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 560 S Bellview, Mesa, AZ 85204 Phone: 276-623-7851 | |
| Mari Michelle Hooper, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 646 S Sabrina, Mesa, AZ 85208 Phone: 480-628-8370 | |
| Mrs. Marguerite R Galindo, MS, FNP-C, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6015 E Brown Rd, Mesa, AZ 85205 Phone: 480-266-4436 |