MEDICARE: DR. MARCO PAUL HOLGADO D.P.M.

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	213E00000X	Podiatrist	E1-0000139	DE

General Provider Information

NPI Number	:	1760541528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCO PAUL HOLGADO D.P.M.

Provider Business Mailing Address
First Line	:	1177 S GOVERNORS AVE STE B
Second Line	:
City	:	DOVER
State	:	DE
Zip	:	19904-6903
Country	:	US
Telephone Number	:	302-678-4612
Fax Number	:	302-678-4614

Provider Business Practice Location Address
First Line	:	1177 S GOVERNORS AVE STE B
Second Line	:
City	:	DOVER
State	:	DE
Zip	:	19904-6903
Country	:	US
Telephone Number	:	302-678-4612
Fax Number	:	302-678-4614

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2006
Last Update Date	:	04/10/2024

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