Provider Demographics
NPI:1639311681
Name:TONGCO, CESAREO AMADEO URBANO II (MD)
Entity type:Individual
Prefix:
First Name:CESAREO AMADEO
Middle Name:URBANO
Last Name:TONGCO
Suffix:II
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 1:1884 BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-3007
Mailing Address - Country:US
Mailing Address - Phone:740-502-4662
Mailing Address - Fax:
Practice Address - Street 1:440 BROWNS LN
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-2044
Practice Address - Country:US
Practice Address - Phone:740-622-0332
Practice Address - Fax:740-622-0335
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301093075207QS0010X
OH35096724207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine