Provider Demographics
NPI:1265431027
Name:ENG, SIMONA C (DO)
Entity type:Individual
Prefix:
First Name:SIMONA
Middle Name:C
Last Name:ENG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5422
Mailing Address - Country:US
Mailing Address - Phone:410-543-7536
Mailing Address - Fax:410-543-7272
Practice Address - Street 1:100 E CARROLL ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5422
Practice Address - Country:US
Practice Address - Phone:410-543-7536
Practice Address - Fax:410-543-7272
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDH0057410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD757000700Medicaid
DE1000032900Medicaid
DE1000032900Medicaid
H53196Medicare UPIN