Brianne C Waggoner DO PC
Emergency Medicine in Mount Clemens, MI. Organization (NPI-2).
NPI number1083059562
StatusActive
Last updated in NPPESMay 9, 2013
Details
- NPI
- 1083059562
- Entity type
- Organization (NPI-2)
- Legal business name
- Brianne C Waggoner DO PC
- Organization subpart
- No
- Enumeration date
- May 9, 2013
- Last updated
- May 9, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 5101017372 | MI | Yes |
Practice location
1000 Harrington StMount Clemens, MI 48043-2920
Phone 586-493-8000
Mailing address
9301 S Western AveOklahoma City, OK 73139-2767
Phone 866-321-8433
Authorized official
Brianne C Waggoner
Owner
5179279287
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