Basic Information
| Provider Information | |||||||||
| NPI: | 1598758443 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DROGULA | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | LOUISE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 203 HOSPITAL DR | ||||||||
| Address2: | SUITE B100 | ||||||||
| City: | GLEN BURNIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210616904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105538351 | ||||||||
| FaxNumber: | 4105538352 | ||||||||
| Practice Location | |||||||||
| Address1: | 203 HOSPITAL DR | ||||||||
| Address2: | SUITE B100 | ||||||||
| City: | GLEN BURNIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210616904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105538351 | ||||||||
| FaxNumber: | 4105538352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2005 | ||||||||
| LastUpdateDate: | 11/04/2009 | ||||||||
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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 | 208600000X | D0044654 | MD | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 5353197 | 01 | AETNA PPO | OTHER | P00254286 | 01 | MD | MEDICARE RAILROAD | OTHER | 2131125 | 01 | MAMSI | OTHER | 406923400 | 05 | MD | MEDICAID | 1303080 | 01 | CIGNA | OTHER | 1622878 | 01 | UNITED HEALTH CARE | OTHER | 645177-01 | 01 | MD | CAREFIRST BCBS | OTHER | 33525 | 01 | JOHN HOPKINS HEALTH CARE | OTHER | 520689917 | 01 | FIDELITY | OTHER | 704197 | 01 | NCPPO | OTHER | J6860006 | 01 | DC | CAREFIRST BCBS | OTHER | 3767375 | 01 | AETNA HMO | OTHER | 520689917-1 | 01 | CONVENTRY | OTHER |