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General NPI Number Information
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NPI Number | 1437101359
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Entity Type | Individual
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Provider Name | MICHAEL P WANGER MD
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 516 LAKEVIEW RD BLDG 4
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City | CLEARWATER
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State | FL
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Zip | 33756-3302
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Country | US
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Telephone | 727-461-7908
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Fax | 727-223-5269
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Provider Business Mailing Address
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Address Line | 1007 JEFFORDS ST STE 101
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City | CLEARWATER
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State | FL
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Zip | 33756-4082
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Country | US
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Telephone | 727-461-7908
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Fax | 727-223-5269
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0072212
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License Number State | FL
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