Provider Demographics
NPI:1588161640
Name:MOGK, LAUREN MALIA (DO)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MALIA
Last Name:MOGK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2345 COURT DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2151
Mailing Address - Country:US
Mailing Address - Phone:704-865-0077
Mailing Address - Fax:704-867-6401
Practice Address - Street 1:210 BEATTY DR STE 100
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-2716
Practice Address - Country:US
Practice Address - Phone:704-266-3100
Practice Address - Fax:704-867-6401
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2025-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2022-00660208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation