Provider Demographics
NPI:1811984701
Name:BAGEAC, MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:BAGEAC
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 1:780 ROUTE 37 W
Mailing Address - Street 2:SUITE 310
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5059
Mailing Address - Country:US
Mailing Address - Phone:732-240-0599
Mailing Address - Fax:732-240-3039
Practice Address - Street 1:780 ROUTE 37 W
Practice Address - Street 2:SUITE 310
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5059
Practice Address - Country:US
Practice Address - Phone:732-240-0599
Practice Address - Fax:732-240-3039
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA049932174400000X
NJ25MA04993200207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD046326OtherCDS
NJMA049932OtherLICENSE
NJ0256901Medicaid
NJMA049932OtherLICENSE
NJMA049932OtherLICENSE
NJ0256901Medicaid