MEDICARE: DR. MARINA MANGAOANG GARCIA 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
1	208000000X	Pediatrics Physician	D0057369	MD
2	208000000X	Pediatrics Physician	C10005760	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467453035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARINA MANGAOANG GARCIA M.D.

Provider Business Mailing Address
First Line	:	409 NATTULL DR RD
Second Line	:
City	:	BEAR
State	:	DE
Zip	:	19701-4909
Country	:	US
Telephone Number	:	302-838-0904
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 RYAN DR
Second Line	:
City	:	RISING SUN
State	:	MD
Zip	:	21911-1840
Country	:	US
Telephone Number	:	410-658-1300
Fax Number	:	410-658-1828

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	07/08/2007

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