Provider Demographics
NPI:1720347248
Name:LAURA K GANGER, M.D. P.C.
Entity Type:Organization
Organization Name:LAURA K GANGER, M.D. P.C.
Other - Org Name:GANGER DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GANGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-717-0351
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty