Provider Demographics
NPI:1568671535
Name:GANGER, LAURA KATHLEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:KATHLEEN
Last Name:GANGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1979 HURON PKWY
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4141
Mailing Address - Country:US
Mailing Address - Phone:734-344-4567
Mailing Address - Fax:734-669-1104
Practice Address - Street 1:1979 HURON PKWY
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4141
Practice Address - Country:US
Practice Address - Phone:734-344-4567
Practice Address - Fax:734-669-1104
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081952207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology