Individual
DR. MARIO S BANGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
17095
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130013055
RAILROAD MEDICARE
SC
05
—
170950
—
SC
01
—
7906457
INDIVIDUAL
NC
Enumeration date
03/15/2006
Last updated
03/19/2020
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