Individual
GREGORY T. LAGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
607 CHESTNUT STREET, SOUTH CHARLESTON, WV 25309-1205
(304) 766-9136
(304) 766-9139
Mailing address
607 CHESTNUT STREET, SOUTH CHARLESTON, WV 25309-1205
(304) 766-9136
(304) 766-9139
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
1300
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0043648000
—
WV
Enumeration date
07/18/2005
Last updated
02/01/2008
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