| Mario S. Bangco, Md, Pa | |
|
170 Waccamaw Medical Park Ct Conway SC 29526-8965 | |
| (843) 347-4473 | |
| (843) 347-0290 |
| Full Name | Mario S. Bangco, Md, Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 170 Waccamaw Medical Park Ct, Conway, South Carolina |
| Authorized Official Name and Position | Mario S Bangco (PRESIDENT) |
| Authorized Official Contact | 8433474473 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mario S. Bangco, Md, Pa 170 Waccamaw Medical Park Ct Conway SC 29526-8965 Ph: (843) 347-4473 | Mario S. Bangco, Md, Pa 170 Waccamaw Medical Park Ct Conway SC 29526-8965 Ph: (843) 347-4473 |
| NPI Number | 1093876435 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 10/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093876435 | NPI | - | NPPES |
| DF8711 | Other | SC | RAILROAD MEDICARE |
| 890195R | Other | NC | NC MCAID GROUP # |
| GP4131 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 17095 (South Carolina) | Primary |
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