Individual
DR. CIRIACO G. BONGALOS, JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1025 S GOVERNORS AVE, DOVER, DE 19904-6901
(302) 734-9150
(302) 734-3931
Mailing address
1025 S GOVERNORS AVE, DOVER, DE 19904-6901
(302) 734-9150
(302) 734-3931
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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