Provider Demographics
NPI:1598757999
Name:SY, ANGELITO CABACAB (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELITO
Middle Name:CABACAB
Last Name:SY
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 41209
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-1209
Mailing Address - Country:US
Mailing Address - Phone:910-609-6448
Mailing Address - Fax:910-609-7040
Practice Address - Street 1:1708A OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3419
Practice Address - Country:US
Practice Address - Phone:910-307-7330
Practice Address - Fax:910-307-7334
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2011-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC95-01436208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8981301Medicaid
NCG58121Medicare UPIN