Provider Demographics
NPI:1356344816
Name:TANCHANCO, RODRIGO CORDERO (MD)
Entity type:Individual
Prefix:DR
First Name:RODRIGO
Middle Name:CORDERO
Last Name:TANCHANCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:102 SLEEPY HOLLOW DR
Mailing Address - Street 2:STE 101
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8894
Mailing Address - Country:US
Mailing Address - Phone:302-376-9888
Mailing Address - Fax:302-376-9160
Practice Address - Street 1:102 SLEEPY HOLLOW DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-5841
Practice Address - Country:US
Practice Address - Phone:302-376-9888
Practice Address - Fax:302-376-9160
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10004917207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE003268I23Medicare PIN
G48342Medicare UPIN