Provider Demographics
NPI:1053662379
Name:MONGEAU, MARC THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:THOMAS
Last Name:MONGEAU
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Gender:M
Credentials:DO
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Mailing Address - Street 1:900 MEDICAL CENTER DR STE 205
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2358
Mailing Address - Country:US
Mailing Address - Phone:844-542-2273
Mailing Address - Fax:856-553-4390
Practice Address - Street 1:435 HURFFVILLE CROSS KEYS RD
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012
Practice Address - Country:US
Practice Address - Phone:856-513-4124
Practice Address - Fax:856-302-3926
Is Sole Proprietor?:No
Enumeration Date:2012-09-26
Last Update Date:2019-02-01
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB10141500207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease