Provider Demographics
NPI:1447343652
Name:GAGO, LAURA APRIL (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:APRIL
Last Name:GAGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:L.
Other - Middle Name:APRIL
Other - Last Name:GAGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2305 GENOA BUSINESS PARK DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7004
Mailing Address - Country:US
Mailing Address - Phone:810-227-3232
Mailing Address - Fax:
Practice Address - Street 1:2305 GENOA BUSINESS PARK DR
Practice Address - Street 2:SUITE 180
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7004
Practice Address - Country:US
Practice Address - Phone:810-227-3232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301069923207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4630655Medicaid
MI4630655Medicaid