Healthcare Provider Details

I. General information

NPI: 1841237211
Provider Name (Legal Business Name): NAPOLEON CUENCO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 12/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GLENDALE RD
GALAX VA
24333-2208
US

IV. Provider business mailing address

200 HOSPITAL DR
GALAX VA
24333-2227
US

V. Phone/Fax

Practice location:
  • Phone: 276-236-1699
  • Fax:
Mailing address:
  • Phone: 276-236-1699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101050132
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: