Individual
JEANNETTE LIA GAGGINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
121 BULKLEY ST, KALAMAZOO, MI 49006-3262
(269) 385-4701
Mailing address
121 BULKLEY ST, KALAMAZOO, MI 49006-3262
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301405993
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4467369
—
MI
Enumeration date
01/25/2006
Last updated
01/25/2023
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