Individual
MARY GRACE TANGUILAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 BOX HILL CORPORATE CENTER DR STE 100, ABINGDON, MD 21009-1251
(410) 671-0017
(410) 671-7072
Mailing address
3401 BOX HILL CORPORATE CENTER DR STE 100, ABINGDON, MD 21009-1251
(410) 671-0017
(410) 671-7072
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D00077329
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164853560
NPI
—
Enumeration date
12/10/2013
Last updated
01/22/2015
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