Individual
DR. CIRIACO G. BONGALOS, JR.
Active
Individual
DR. CIRIACO G. BONGALOS, JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C10001931
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000088201
—
DE
01
—
26436
COVENTRY HEALTH CARE
DE
01
—
AETNA
18151
DE
Enumeration date
04/05/2006
Last updated
11/24/2009
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