Provider Demographics
NPI:1225018658
Name:BILLMAYER, ANGELA C (OD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:C
Last Name:BILLMAYER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5394 TWIN HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5682
Mailing Address - Country:US
Mailing Address - Phone:804-270-1040
Mailing Address - Fax:804-270-7140
Practice Address - Street 1:5394 TWIN HICKORY RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-5682
Practice Address - Country:US
Practice Address - Phone:804-270-1040
Practice Address - Fax:804-270-7140
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000972152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00W988E01Medicare PIN
U38707Medicare UPIN