Provider Demographics
NPI:1427010701
Name:LAGO, STEPHEN MATTHEW (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MATTHEW
Last Name:LAGO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-274-6657
Mailing Address - Fax:717-270-6615
Practice Address - Street 1:720 NORMAN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7481
Practice Address - Country:US
Practice Address - Phone:717-274-6657
Practice Address - Fax:717-270-6615
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-012237207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009423160001Medicaid
PAPO1797415OtherRAILROAD MEDICARE
PA1009423160004Medicaid
PAPO1797415OtherRAILROAD MEDICARE
PA230389WFHMedicare PIN
PA1009423160004Medicaid