Provider Demographics
NPI:1053329524
Name:HOLGADO, MARCO PATRICK (DO)
Entity Type:Individual
Prefix:DR
First Name:MARCO
Middle Name:PATRICK
Last Name:HOLGADO
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Gender:M
Credentials:DO
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Mailing Address - Street 1:404 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:859-504-8029
Practice Address - Street 1:406 ROUTE 23
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NJ
Practice Address - Zip Code:07416-2132
Practice Address - Country:US
Practice Address - Phone:973-827-2120
Practice Address - Fax:973-827-9445
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2021-12-10
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Provider Licenses
StateLicense IDTaxonomies
NJMB068708207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH17081Medicare UPIN