Bagley, Michael P

Bagley, Michael P is an individual health care provider with primary practice located at 122 Mt Bethel Rd Ste 1 Warren Dermatology Assoc Llc, Warren NJ 07059. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Bagley, Michael P can be contacted via phone (908) 756-7999.

Contact Information

Primary practice address
122 Mt Bethel Rd Ste 1 Warren Dermatology Assoc Llc Warren NJ 07059
Phone: (908) 756-7999
Fax: (908) 756-8017
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 25MA04581000 New Jersey

Profile Details

NPI number 1790703486
LBN Legal business name Bagley, Michael P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Feb 13th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790703486 NPPES
New Jersey Other 223824190 GROUP TAX ID

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