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General NPI Number Information
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NPI Number | 1528354768
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Entity Type | Individual
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Provider Name | FABIAN PHILEMON NGIDO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2011
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 424 SAVANNAH RD
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City | LEWES
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State | DE
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Zip | 19958-1462
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Country | US
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Telephone | 302-645-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 33640 UNION CIR
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City | LEWES
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State | DE
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Zip | 19958-9435
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Country | US
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Telephone | 252-364-7755
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 51472
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101261875
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA11663500
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | D0099613
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C1-0024774
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License Number State | DE
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