Basic Information
| Provider Information | |||||||||
| NPI: | 1265634166 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AGCAOILI | ||||||||
| FirstName: | CECILY MARIE | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11055 LITTLE PATUXENT PKWY | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210442896 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107402900 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11055 LITTLE PATUXENT PKWY | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210442896 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107402900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2007 | ||||||||
| LastUpdateDate: | 05/26/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D0070589 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.