Individual
DR. ANDREW K GAVAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1080 KIRTS BLVD, SUITE 700, TROY, MI 48084-4881
(248) 369-9300
(248) 362-5272
Mailing address
1080 KIRTS BLVD, SUITE 700, TROY, MI 48084-4881
(248) 369-9300
(248) 362-5272
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
01096238A
IN
208200000X
Plastic Surgery Physician
Primary
4301057593
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349596810
—
MI
Enumeration date
11/21/2005
Last updated
06/17/2025
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