Provider Demographics
NPI:1265635809
Name:HAUGO, ANGELA REA (DO)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:REA
Last Name:HAUGO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-2861
Mailing Address - Country:US
Mailing Address - Phone:406-777-5522
Mailing Address - Fax:
Practice Address - Street 1:715 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-2861
Practice Address - Country:US
Practice Address - Phone:406-777-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12829207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT8867672Medicare PIN