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General NPI Number Information
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NPI Number | 1942242557
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Entity Type | Individual
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Provider Name | DONGHO BAAG M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 07/12/2015
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Provider Practice Location Address
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Address Line | 9 OKLAHOMA STATE DR
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City | NEWARK
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State | DE
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Zip | 19713-1142
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Country | US
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Telephone | 302-584-4853
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Fax | 302-397-2900
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Provider Business Mailing Address
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Address Line | 361 BOILER HOUSE RD
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City | PERRY POINT
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State | MD
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Zip | 21902-1103
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Country | US
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Telephone | 410-642-2411
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Fax | 410-642-1825
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C10005050
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License Number State | DE
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