Felizardo Hocbo Mangundayao, MD
Individual provider Active NPI Family Medicine Physician · Denton, NC
NPI 1104997147 · NPPES record last updated Dec 13, 2010
Key facts
- NPI
- 1104997147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 21999 (NC)
- Practice address
- 292 South Main St.
Denton, NC 27239 - Phone
- (336) 859-2121
- Fax
- (336) 859-2122
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21999 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FH Mangundayao & FC Mangundayao PTR | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21999 | NC | Yes |
Addresses
Primary practice location
292 South Main St.
Denton, NC 27239
Mailing address
PO Box 1470
Denton, NC 27239
Phone (336) 859-2121
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890191A | Medicaid | NC |
Other providers in Denton, NC
- Christie Renee Jarrell-Smith
- Averille Kinley
- Legacy Healthcare
- Emily Logan
- Olivia Lorenz
- Wendy Sutts McLeod
- Misty Nichols Mize
- Mountain Vista Health Park, Inc.
- Mountain Vista Health Park, Inc.
- NH Med Operator LLC
All providers in Denton, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.