NPI 1083906952

Matthew David Wagaman, MD

Practitioner Anesthesiology Physician Provo, UT

Practice location

Address: 1034 N 500 W, Provo, UT 84604-3380
Phone: (801) 357-7850
Fax: (770) 701-6675
Mailing address: PO Box 3570, Salt Lake City, UT 84110-3570

Registered specialties (3)

Anesthesiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207L00000X Licence 22241 (ND)

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Anesthesiology Physician

Allopathic & Osteopathic Physicians Taxonomy 207L00000X Licence 4301096041 (MI)

Anesthesiology Physician

Allopathic & Osteopathic Physicians Taxonomy 207L00000X Licence 9395169-1205 (UT)

Registry record

NPI: 1083906952
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 May 2011
Record last updated: 24 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.