Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MT186498 | PA |
Y | 207VX0201X | Gynecologic Oncologist | C1-0008694 | DE |
NPI | 1154476190 |
---|---|
Provider Name | Mark G Cadungog |
First Address | Newark, DE 19713-2049 |
Second Address | Newark, DE 19713-7016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 16/10/2017 |