Provider Demographics
NPI:1003858051
Name:HOWARD, ANGUS C JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGUS
Middle Name:C
Last Name:HOWARD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 HURRICANE SHOALS RD NW STE 100
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-8762
Mailing Address - Country:US
Mailing Address - Phone:404-645-7150
Mailing Address - Fax:
Practice Address - Street 1:595 HURRICANE SHOALS RD NW STE 100
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046
Practice Address - Country:US
Practice Address - Phone:404-645-7150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030099207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000470401CMedicaid
GA000470401FMedicaid
GA000470401HMedicaid
GA1634458OtherCIGNA
GA000470401GMedicaid
110051099OtherRAILROAD MEDICARE
GA000470401EMedicaid
GA3106162OtherUNITED HEALTH CARE
GA000470401AMedicaid
GA28257OtherBCBS
GA505559OtherAETNA
GA000470401DMedicaid
GA000470401IMedicaid
GA000470401KMedicaid
GA000470401OMedicaid
GA000470401QMedicaid
GA000470401GMedicaid
GA000470401CMedicaid
GA11BDDGTMedicare PIN