Provider Demographics
NPI:1265921191
Name:GOGUE PEDIATRICS, P.C.
Entity type:Organization
Organization Name:GOGUE PEDIATRICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOGUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-446-8060
Mailing Address - Street 1:39242 DEQUINDRE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-1764
Mailing Address - Country:US
Mailing Address - Phone:586-446-8060
Mailing Address - Fax:586-446-8062
Practice Address - Street 1:39242 DEQUINDRE RD STE 101
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-1764
Practice Address - Country:US
Practice Address - Phone:586-446-8060
Practice Address - Fax:586-446-8062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty