| NPI Details | |
|---|---|
| NPI | 1790871093 |
| Gender | Female |
| Enumeration Date | 10/05/2006 |
| Last Updated | 07/08/2007 |
| Entity Type | Individual |
| Active | Over 10 years ago |
| Practice Location | |
|---|---|
| 751 LAFAYETTE AVE NE GRAND RAPIDS MI, 49503-1628, US |
|
| Phone | (616) 742-9945 |
| Fax | (616) 742-9967 |
| Business Location | |
|---|---|
| 1384 E JEFFERSON RD HART MI, 49420-8301, US |
|
| Phone | (616) 742-9945 |
| Fax | (616) 742-9967 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207Q00000X |
| License State | Michigan |
| License Number | 4301087952 |
| Remove 1790871093 NPI Number | |
According to our database, Stacia Gilde Marie Lagarde M.D. NPI is 1790871093, taxonomy code is 207Q00000X and license number is 4301087952, license state is located at Michigan. Stacia Gilde Marie Lagarde M.D. physically located at 751 Lafayette Ave Ne, Grand Rapids MI, 49503-1628. NPI Number Stacia Gilde Marie Lagarde M.D. has the Individual type.
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1790871093 NPI number is provided on an as is basis without warranty of any kind. 1790871093 is maintained by the National Plan & Provider Enumeration System. The contents of Stacia Gilde Marie Lagarde M.D. are for informational purposes only.
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