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Contact Information

MARIE BROWN WAGNER, MD
US HWY 491 NORTH
SHIPROCK, NM87420
 Phone: 505-368-6401
 Fax: 505-368-6431
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for MARIE BROWN WAGNER · (Female)

NPI Number 1134235385
Status Active
Credentials MD
Entity Individual
Enumeration date 08/21/2006
Last updated 02/02/2012 - About 14 years ago
Sole proprietor 1 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(s) Not Available
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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