Basic Information
| Provider Information | |||||||||
| NPI: | 1891765939 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BATONG | ||||||||
| FirstName: | SYLVIA | ||||||||
| MiddleName: | BONGERS | ||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 110 HOSPITAL RD | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | PRINCE FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206784039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105354488 | ||||||||
| FaxNumber: | 4105356131 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 HOSPITAL RD | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | PRINCE FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206784039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105354488 | ||||||||
| FaxNumber: | 4105356131 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2006 | ||||||||
| LastUpdateDate: | 09/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | D43306 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2178716 | 01 | AETNA | OTHER | 291569 | 01 | MAMSI | OTHER | T5080002 | 01 | CAREFIRST-FEDERAL | OTHER | KS56 | 01 | MD | CAREFIRST-MARYLAND | OTHER | 183641200 | 05 | MD | MEDICAID |