Provider Demographics
NPI:1780070714
Name:KAGAN, MICHAEL DENNIS (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DENNIS
Last Name:KAGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 CARY HALL
Mailing Address - Street 2:UB OFFICE OF GRADUATE MEDICAL EDUCATION
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-3023
Mailing Address - Country:US
Mailing Address - Phone:716-829-2012
Mailing Address - Fax:716-829-3999
Practice Address - Street 1:117 CARY HALL
Practice Address - Street 2:UB OFFICE OF GRADUATE MEDICAL EDUCATION
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-3023
Practice Address - Country:US
Practice Address - Phone:716-829-2012
Practice Address - Fax:716-829-3999
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program