Individual
MAVERICK MABAGOS MANGOSING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 215-4033
Mailing address
4121 BALINGTON DR, VALRICO, FL 33596-6501
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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