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NPI Code Detail

MEDICARE: DR. PAUL LUKE GOGUE M.D.

MEDICARE:  DR. PAUL LUKE GOGUE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician4301101197MI

General Provider Information

NPI Number : 1104172212
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL LUKE GOGUE M.D.
Provider Business Mailing Address
First Line : 39242 DEQUINDRE RD
Second Line : SUITE 101
City : STERLING HEIGHTS
State : MI
Zip : 48310-1764
Country : US
Telephone Number : 586-446-8060
Fax Number :
Provider Business Practice Location Address
First Line : 39242 DEQUINDRE RD
Second Line : SUITE 101
City : STERLING HEIGHTS
State : MI
Zip : 48310-1764
Country : US
Telephone Number : 586-446-8060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2012
Last Update Date : 01/10/2025

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Directions to “ DR. PAUL LUKE GOGUE M.D.” Practice Location

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