Individual ProviderAngela VanwagnerEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address1105 Sixth St, Traverse City, MI 49684-2345(231) 935-5000(231) 947-0673PECOS EnrollmentBased on the most recent information from CMS, provider Angela Vanwagner is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 11 days ago.Profile DetailsProvider ID1548642465Provider TypeIndividualFull NameVanwagner, AngelaTitleDr.CredentialDOGenderFemaleSole ProprietorNoEnumeration Date6/27/2015Last Updated7/26/2023Contact InformationPractice LocationPractice Address1105 Sixth St, Traverse City, MI 49684-2345Phone(231) 935-5000FaxUnlisted FaxMailing LocationMailing Address4624 N Spider Lake Rd, Traverse City, MI 49696-8440Phone(231) 947-0673Fax(801) 740-2847Provider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicense5101021607Michigan