Organization
PALM COAST ONCOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP NDEP NDUM M.D (PRESIDENT OF CORPORATION)
(386) 586-2889
Entity
Organization
Contact information
Practice address
61 MEMORIAL MEDICAL PKWY, SUITE 3808, PALM COAST, FL 32164-5981
(386) 586-2889
(386) 586-2890
Mailing address
61 MEMORIAL MEDICAL PKWY, SUITE 3808, PALM COAST, FL 32164-5981
(386) 586-2889
(386) 586-2890
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME88511
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME88511
STATE MEDICAL LICENSE
FL
Enumeration date
09/27/2007
Last updated
04/20/2008
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