Provider Demographics
NPI:1750351110
Name:LAGO, DAYNA M (MD)
Entity type:Individual
Prefix:MRS
First Name:DAYNA
Middle Name:M
Last Name:LAGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:241 CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4965
Mailing Address - Country:US
Mailing Address - Phone:757-622-2200
Mailing Address - Fax:757-622-4866
Practice Address - Street 1:241 CORPORATE BLVD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4965
Practice Address - Country:US
Practice Address - Phone:757-622-2200
Practice Address - Fax:757-622-4866
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051282207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1750351110Medicaid
VA344008OtherANTHEM
VA541150779OtherTRICARE
VA016331V49OtherMEDICAR