National Provider Identifier Database

MARIE BROWN WAGNER, MD – NPI #1134235385
Plastic Surgery within the Head & Neck

An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.


Contact Information

MARIE BROWN WAGNER, MD
US HWY 491 NORTH
SHIPROCK, NM87420
Phone: 505-368-6401
Fax: 505-368-6431
Website:
Specialty Taxonomy Code
* Plastic Surgery within the Head & Neck 207YX0007X
Otolaryngology 207Y00000X

* Indicates primary specialty

NPI Profile & details for MARIE BROWN WAGNER

NPI Number 1134235385
Credentials MD
Entity Individual
Enumeration date 08/21/2006
Last updated 02/02/2012 - About 14 years ago
Sole proprietor1 No
Identifiers
  • CO License #: 50773
  • NY License #: 131753-2
  • AZ Medicaid: 621830
  • CO Medicaid: 23083336
  • NM Medicaid: G7888
  • CO Other: 022392 KAISER COMMERCIAL NUMBER
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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