Provider Demographics
NPI:1891765939
Name:BATONG, SYLVIA BONGERS (MD)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:BONGERS
Last Name:BATONG
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 1:110 HOSPITAL RD STE 111
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4039
Mailing Address - Country:US
Mailing Address - Phone:410-535-4488
Mailing Address - Fax:443-771-8114
Practice Address - Street 1:110 HOSPITAL RD STE 111
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4039
Practice Address - Country:US
Practice Address - Phone:410-535-4488
Practice Address - Fax:443-771-8114
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD43306207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2178716OtherAETNA
291569OtherMAMSI
MD183641200Medicaid
T5080002OtherCAREFIRST-FEDERAL
MDKS56OtherCAREFIRST-MARYLAND
291569OtherMAMSI
2178716OtherAETNA
MD183641200Medicaid