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NPI Code Detail

MEDICARE: DR. EMMANUEL A BAYONGAN M.D.

MEDICARE:  DR. EMMANUEL A BAYONGAN  M.D.
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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianE3687AR
2207RP1001XPulmonary Disease PhysicianE3687AR
3207RC0200XCritical Care Medicine (Internal Medicine) Physician36739AZ
4207RP1001XPulmonary Disease Physician36739AZ

General Provider Information

NPI Number : 1003808668
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMMANUEL A BAYONGAN M.D.
Provider Business Mailing Address
First Line : 2145 W SOUTHERN AVE # 264
Second Line :
City : MESA
State : AZ
Zip : 85202-4715
Country : US
Telephone Number : 480-543-2034
Fax Number : 480-512-6089
Provider Business Practice Location Address
First Line : 1400 S DOBSON RD
Second Line :
City : MESA
State : AZ
Zip : 85202-4707
Country : US
Telephone Number : 480-543-2034
Fax Number : 480-512-6089
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 10/04/2012

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Directions to “ DR. EMMANUEL A BAYONGAN M.D.” Practice Location

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