Provider Demographics
NPI:1255075701
Name:BAGINGITO, MORGAN
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:BAGINGITO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MDG BUILDING 777 SONGTAN BLVD
Mailing Address - Street 2:UNIT 2060
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96278
Mailing Address - Country:US
Mailing Address - Phone:315-784-2500
Mailing Address - Fax:
Practice Address - Street 1:51 MDG BUILDING 777 SONGTAN BLVD
Practice Address - Street 2:UNIT 2060
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96278
Practice Address - Country:US
Practice Address - Phone:315-784-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
CA390200000X
NE36113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171000000XOther Service ProvidersMilitary Health Care Provider
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program