JEFFERY DALE WIRGAU — Medicare Enrolled Provider (PRACTITIONER - PHYSICIAN ASSISTANT, MI)
JEFFERY DALE WIRGAU — Medicare Enrolled Provider (PRACTITIONER - PHYSICIAN ASSISTANT, MI) is one of 9,000 enrolled providers in the MedicareEnroll dataset. Key details — Name: JEFFERY DALE WIRGAU; Type: Individual; NPI: 1003122169.
| Name | JEFFERY DALE WIRGAU |
|---|---|
| Type | Individual |
| NPI | 1003122169 |
| Provider type | PRACTITIONER - PHYSICIAN ASSISTANT |
| State | MI |
| Enrollment ID | I20110411000165 |
| Multiple NPI flag | N |
| Source | CMS Medicare FFS Public Provider Enrollment (PECOS) |
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