Provider Demographics
NPI:1649248691
Name:MUNDLE, CYNTHIA WOOD (MD)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:WOOD
Last Name:MUNDLE
Suffix:
Gender:
Credentials:MD
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:WOOD
Other - Last Name:HUFFAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:51 GREENWOOD SHOALS
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21638
Mailing Address - Country:US
Mailing Address - Phone:410-490-6055
Mailing Address - Fax:410-758-2185
Practice Address - Street 1:160 COURSEVALL DR
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617-1824
Practice Address - Country:US
Practice Address - Phone:443-262-4100
Practice Address - Fax:410-758-2185
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052783207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCJ1740004OtherCAREFIRST
MD264410000Medicaid
MD5478560ZOtherCAREFIRST
DCJ1740004OtherCAREFIRST
MD264410000Medicaid
G6915Medicare UPIN