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Organization

MAURA BAGOS, D.O., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAURA LYNN BAGOS D.O. (DOCTOR)
(248) 244-8545
Entity
Organization

Contact information

Practice address
2701 TROY CENTER DR STE 260, TROY, MI 48084-4741
(248) 244-8545
(248) 244-8582
Mailing address
2701 TROY CENTER DR STE 260, TROY, MI 48084-4741
(248) 244-8545
(248) 244-8582

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MB011649
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1156303474
BCBSM
MI
05
4130308
MI
Enumeration date
07/05/2006
Last updated
08/01/2008
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