MEDICARE: CECILE C. DEL MUNDO, MD, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	35193	KY

General Provider Information

NPI Number	:	1548428097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CECILE C. DEL MUNDO, MD, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 1706
Second Line	:
City	:	CORBIN
State	:	KY
Zip	:	40702-1706
Country	:	US
Telephone Number	:	606-330-0566
Fax Number	:	606-330-0496

Provider Business Practice Location Address
First Line	:	202 W 7TH ST
Second Line	:	STE 201
City	:	LONDON
State	:	KY
Zip	:	40741-1763
Country	:	US
Telephone Number	:	606-330-0566
Fax Number	:	606-330-0496

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CECILE C. DEL MUNDO
Credential	:	MD
Telephone Number	:	606-330-0566

Provider Enumeration Date	:	05/30/2008
Last Update Date	:	06/30/2008

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