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General NPI Number Information
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NPI Number | 1912165291
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Entity Type | Organization
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Legal Business Name | GAGO CENTER FOR FERTILITY, PLLC
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Dates
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Enumeration Date | 05/23/2008
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 2305 GENOA BUSINESS PARK DR SUITE 180
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City | BRIGHTON
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State | MI
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Zip | 48114-7004
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Country | US
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Telephone | 810-227-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 2305 GENOA BUSINESS PARK DR SUITE 180
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City | BRIGHTON
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State | MI
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Zip | 48114-7004
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | LAURA GAGO
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Credential |
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Telephone | 810-227-3232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number |
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License Number State |
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