Individual
LUIS C. GAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2350 E STADIUM BLVD, SUITE 10, ANN ARBOR, MI 48104-4889
(877) 852-8463
(734) 994-6283
Mailing address
850 W NORTH ST STE 104, JACKSON, MI 49202-3196
(877) 852-8463
(571) 817-0144
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301076027
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386704781
—
MI
01
—
180H149970
BCBSM
MI
01
—
180H262240
BLUE CROSS-BLUE CROSS
—
05
—
467549710
—
MI
01
—
LG076027
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
12/08/2006
Last updated
09/20/2018
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