MEDICARE: DR. MICHAEL DENNIS KAGAN 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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1780070714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DENNIS KAGAN M.D.

Provider Business Mailing Address
First Line	:	117 CARY HALL
Second Line	:	UB OFFICE OF GRADUATE MEDICAL EDUCATION
City	:	BUFFALO
State	:	NY
Zip	:	14214-3023
Country	:	US
Telephone Number	:	716-829-2012
Fax Number	:	716-829-3999

Provider Business Practice Location Address
First Line	:	117 CARY HALL
Second Line	:	UB OFFICE OF GRADUATE MEDICAL EDUCATION
City	:	BUFFALO
State	:	NY
Zip	:	14214-3023
Country	:	US
Telephone Number	:	716-829-2012
Fax Number	:	716-829-3999

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2015
Last Update Date	:	04/07/2015

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