Provider Demographics
NPI:1548367204
Name:NAGORI, LOKESH (MD)
Entity type:Individual
Prefix:
First Name:LOKESH
Middle Name:
Last Name:NAGORI
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 1:18223 E 10 MILE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-5821
Mailing Address - Country:US
Mailing Address - Phone:586-778-5880
Mailing Address - Fax:586-778-4362
Practice Address - Street 1:18223 E 10 MILE RD STE 100
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-5821
Practice Address - Country:US
Practice Address - Phone:586-778-5880
Practice Address - Fax:586-778-4362
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2025-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0504207R00000X
MI4301095133207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0500290OtherBCBS
MIN71770005Medicare PIN