Provider Demographics
NPI:1609545557
Name:WARWAS, MICHAEL DANIEL
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DANIEL
Last Name:WARWAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13528 390TH ST
Mailing Address - Street 2:
Mailing Address - City:BAGLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56621-4462
Mailing Address - Country:US
Mailing Address - Phone:218-750-7194
Mailing Address - Fax:
Practice Address - Street 1:13528 390TH ST
Practice Address - Street 2:
Practice Address - City:BAGLEY
Practice Address - State:MN
Practice Address - Zip Code:56621-4462
Practice Address - Country:US
Practice Address - Phone:218-750-7194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife