Provider Demographics
NPI:1821351396
Name:NAGY, REGINA DUPE (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:DUPE
Last Name:NAGY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:REGINA
Other - Middle Name:
Other - Last Name:AGBOOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:745 HASKINS RD STE B
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-1600
Mailing Address - Country:US
Mailing Address - Phone:419-373-7607
Mailing Address - Fax:419-353-7076
Practice Address - Street 1:1214 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-2664
Practice Address - Country:US
Practice Address - Phone:419-352-8427
Practice Address - Fax:419-352-2120
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.132920207VX0000X
MI4301101442207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0258320Medicaid
OHH623341OtherMEDICARE