Individual
DR. MICHAEL P BAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
122 MT BETHEL RD STE 1, WARREN DERMATOLOGY ASSOC LLC, WARREN, NJ 07059
(908) 756-7999
(908) 756-8017
Mailing address
2 INGRAM CIRCLE, ABERDEEN, NJ 07747
(732) 583-3886
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA04581000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223824190
GROUP TAX ID
NJ
Enumeration date
07/18/2006
Last updated
02/13/2013
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