Brian Wanner, D.O.

Dermatology, MOHS-Micrographic Surgery in Mesa, AZ. Individual provider (NPI-1).

NPI number1982137725

StatusActive

Last updated in NPPESJun 21, 2024

Details

NPI: 1982137725
Entity type: Individual (NPI-1)
Name: Brian Wanner
Credential: D.O.
Sex: Male
Sole proprietor: No
Enumeration date: Apr 8, 2017
Certification date: Jun 21, 2024
Last updated: Jun 21, 2024

Medicare and OIG

Medicare enrolled (PECOS): Yes · PRACTITIONER - DERMATOLOGY
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207ND0101X	Dermatology, MOHS-Micrographic Surgery	83813	SC	Yes

Practice location

2250 W Southern Ave Ste 102
Mesa, AZ 85202-4736

Phone 480-835-5532

Mailing address

2250 W Southern Ave Ste 102
Mesa, AZ 85202-4736

Phone 480-835-5532

Other practice locations

1409 N. Fant Street
Anderson, SC 29621

Phone 864-375-7551 · Fax 864-231-8073

485 Tom Hall St Ste 101
Fort Mill, SC 29715-2353

Phone 803-659-3671

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Other MOHS-Micrographic Surgery Physician providers in Mesa, AZ

All 6 MOHS-Micrographic Surgery Physician providers in Mesa · All 13,507 providers in Mesa

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