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General NPI Number Information
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NPI Number | 1710940309
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Entity Type | Organization
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Legal Business Name | VINCENT O. CASIBANG, M.D., P.A.
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9470 ANNAPOLIS RD SUITE 307
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City | LANHAM
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State | MD
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Zip | 20706-3025
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Country | US
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Telephone | 301-731-5944
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Fax | 301-731-9034
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Provider Business Mailing Address
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Address Line | PO BOX 886
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City | LANHAM
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State | MD
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Zip | 20703-0886
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Country | US
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Telephone | 301-731-5944
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Fax | 301-731-9034
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Authorized Official
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Title or Position | CORPORATE PRESIDENT
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Name | VINCENT ONATE CASIBANG
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Credential | M.D.
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Telephone | 301-731-5744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0023927
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License Number State | MD
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