Provider Demographics
NPI:1811135841
Name:GAGUA, IRINA (MD)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:GAGUA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1852
Mailing Address - Country:US
Mailing Address - Phone:629-255-3486
Mailing Address - Fax:629-255-3075
Practice Address - Street 1:4230 HARDING PIKE STE 500
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-4903
Practice Address - Country:US
Practice Address - Phone:629-255-2087
Practice Address - Fax:629-255-4271
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN70290207R00000X
OH35.127337208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35.127337OtherLICENSE
TN70290OtherLICENSE