Provider Demographics
NPI:1144510504
Name:CUBANGBANG, MARICEL MERCADO (MD)
Entity type:Individual
Prefix:
First Name:MARICEL
Middle Name:MERCADO
Last Name:CUBANGBANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 RESERVOIR ROAD NW
Mailing Address - Street 2:DEPT OF OTOLARYNGOLOGY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007
Mailing Address - Country:US
Mailing Address - Phone:202-444-8186
Mailing Address - Fax:202-826-5501
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:DEPT OF OTOLARYNGOLOGY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-444-8186
Practice Address - Fax:202-826-5501
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program