Provider Demographics
NPI:1124005830
Name:TIONGCO, FELIX P (MD)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:P
Last Name:TIONGCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 GAINSBOROUGH SQ
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-1706
Mailing Address - Country:US
Mailing Address - Phone:757-547-0798
Mailing Address - Fax:757-547-0145
Practice Address - Street 1:112 GAINSBOROUGH SQ
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1706
Practice Address - Country:US
Practice Address - Phone:757-547-0798
Practice Address - Fax:757-547-0145
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101059285207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA599126OtherMAMSI/MDIPA
VA159634OtherBCBS OF VA
VA010103045Medicaid
VA21267OtherSENTARA/OPTIMA
VA599126OtherUNITEDHEALTHCARE
VA599126OtherMAMSI/MDIPA
GAP00177565Medicare ID - Type UnspecifiedMEDICARE RAILROAD
VA010103045Medicaid