Provider Demographics
NPI:1003842436
Name:CAGAMPAN, LYNDON B (MD)
Entity type:Individual
Prefix:DR
First Name:LYNDON
Middle Name:B
Last Name:CAGAMPAN
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 1:200 BANNING ST
Mailing Address - Street 2:STE 350
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3485
Mailing Address - Country:US
Mailing Address - Phone:302-730-8848
Mailing Address - Fax:302-730-8846
Practice Address - Street 1:200 BANNING ST
Practice Address - Street 2:STE 350
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3485
Practice Address - Country:US
Practice Address - Phone:302-730-8848
Practice Address - Fax:302-730-8846
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10007996208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation