Individual
DR. GWENNETH O CANCINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
115 W BEL AIR AVENUE, ABERDEEN, MD 21001-3221
(410) 272-3377
(410) 273-1479
Mailing address
115 W BEL AIR AVENUE, ABERDEEN, MD 21001-3221
(410) 272-1692
(410) 272-1694
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0046268
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323951900
—
MD
01
—
53276204
CAREFIRST OF MD
MD
01
—
H9660002
CAREFIRST OF DC
MD
Enumeration date
05/24/2005
Last updated
11/08/2013
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