Provider Demographics
NPI:1851320493
Name:MPINGA, EBONDO (MD)
Entity Type:Individual
Prefix:DR
First Name:EBONDO
Middle Name:
Last Name:MPINGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:300 PINE GROVE CMNS
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5176
Practice Address - Country:US
Practice Address - Phone:717-851-6110
Practice Address - Fax:717-741-1076
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423172208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100835693Medicaid
MD611550OtherCAREFIRST MD BCBS
PA20030444OtherAMERIHEALTH MERCY-WMG
PA147491OtherUNISON-WMG
PA1536272OtherGATEWAY-WMG
PA1542793OtherHIGHMARK BLUE SHIELD
PA2118573OtherMAMSI-WMG
PA90900OtherGEISINGER
PA7172196OtherAETNA
PA2226915000OtherAMERIHEALTH 65 PA
PA031120OtherJOHNS HOPKINS
PA50022713OtherCAPITAL BLUE CROSS-WMG
PA074633FLTMedicare PIN
PAP00120741Medicare PIN
PA1536272OtherGATEWAY-WMG
PA2226915000OtherAMERIHEALTH 65 PA