Individual
DR. JEREMY LAWRENCE GAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-2001
Mailing address
501 E 14 MILE RD, BIRMINGHAM, MI 48009-2094
(248) 593-3193
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01063400A
IN
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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