Provider Demographics
NPI:1841234523
Name:CABUNGCAL, CATHERINE ROY (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ROY
Last Name:CABUNGCAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 COWELL FARM RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3431
Mailing Address - Country:US
Mailing Address - Phone:252-946-2101
Mailing Address - Fax:252-946-9896
Practice Address - Street 1:1380 COWELL FARM RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3431
Practice Address - Country:US
Practice Address - Phone:252-946-2101
Practice Address - Fax:252-946-9896
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200601852207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC145VFOtherBCBS
NC5908296Medicaid
NC8901960OtherEASTERN CAROLINA PHYSICIANS MEDICAID GROUP NUMBER FOR KINSTON
NC5905891Medicaid
NC5908296OtherEASTERN CAROLINA PHYSICIANS MEDICAID GROUP NUMBER FOR BEULAVILLE
NC8901960OtherEASTERN CAROLINA PHYSICIANS MEDICAID GROUP NUMBER FOR KINSTON
PAH03082Medicare UPIN
NC2064572Medicare PIN
NC0326Medicare ID - Type UnspecifiedGROUP NUMBER