Provider Demographics
NPI:1528031663
Name:GAGLIA, MICHAEL ANGELO JR (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANGELO
Last Name:GAGLIA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BOWER HILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:129-421-1444
Mailing Address - Fax:
Practice Address - Street 1:1000 BOWER HILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1873
Practice Address - Country:US
Practice Address - Phone:412-942-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA310562207RI0011X
PAMD426137174400000X, 207RC0000X, 207RI0011X
CAA122707207RC0000X
NMMD2016-0785207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810003910Medicaid
CAW18762OtherGROUP MEDICARE
PA1012944350003Medicaid
CA1902846306OtherGROUP NPI
CAGR0100430OtherGROUP MEDI-CAL
WV3810003910Medicaid
PA221971QJDMedicare PIN
CAGR0100430OtherGROUP MEDI-CAL