Provider Demographics
NPI:1033451182
Name:HOGUE, ANGELA P (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:P
Last Name:HOGUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:P
Other - Last Name:SOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:724-588-5250
Mailing Address - Fax:724-588-5253
Practice Address - Street 1:348 MAIN STREET
Practice Address - Street 2:GREENVILLE COMMUNITY HEALTH CENTER
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-2608
Practice Address - Country:US
Practice Address - Phone:724-588-5250
Practice Address - Fax:724-588-5253
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD456128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0185401Medicaid
PA1031182210001Medicaid