Provider Demographics
NPI:1043457195
Name:ANG, VINCENT PALERACIO (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:PALERACIO
Last Name:ANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VICENTE
Other - Middle Name:PALERACIO
Other - Last Name:ANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:112 ASHTON OAKS CT
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:MD
Mailing Address - Zip Code:20861-9711
Mailing Address - Country:US
Mailing Address - Phone:301-774-1099
Mailing Address - Fax:
Practice Address - Street 1:112 ASHTON OAKS CT
Practice Address - Street 2:
Practice Address - City:ASHTON
Practice Address - State:MD
Practice Address - Zip Code:20861-9711
Practice Address - Country:US
Practice Address - Phone:301-774-1099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0015068207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine