Provider Demographics
NPI:1306230503
Name:KASAGO, ISRAEL S (MD)
Entity type:Individual
Prefix:
First Name:ISRAEL
Middle Name:S
Last Name:KASAGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:1314 N MACOMB ST DEPT OF
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-3131
Practice Address - Country:US
Practice Address - Phone:734-242-6872
Practice Address - Fax:734-242-4962
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI70404-20207ND0900X, 207ZD0900X, 207ZP0102X
MI4301508647207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology