Provider Demographics
NPI:1124206388
Name:HAWKES, ANGELA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:HAWKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 HORSE PEN CREEK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9700
Mailing Address - Country:US
Mailing Address - Phone:336-617-6568
Mailing Address - Fax:336-617-6660
Practice Address - Street 1:2835 HORSE PEN CREEK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-9700
Practice Address - Country:US
Practice Address - Phone:336-617-6568
Practice Address - Fax:336-617-6660
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-00331207RR0500X
DCMD036609207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5913855Medicaid
NC9815389OtherAETNA
NC15720OtherBCBSNC
NC2075775Medicare PIN