Provider Demographics
NPI:1962762609
Name:GAGNON, DANIELLE PAIGE (MD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:PAIGE
Last Name:GAGNON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:PAIGE
Other - Last Name:SCRIBNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:180 KENNEDY MEMORIAL DR
Mailing Address - Street 2:# 204
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4540
Mailing Address - Country:US
Mailing Address - Phone:207-872-5529
Mailing Address - Fax:
Practice Address - Street 1:180 KENNEDY MEMORIAL DR
Practice Address - Street 2:# 204
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4540
Practice Address - Country:US
Practice Address - Phone:207-872-5529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-28
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD21307207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology