Provider Demographics
NPI:1346501756
Name:ANGEVINE, JAMES MURRAY (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MURRAY
Last Name:ANGEVINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 MINERAL PT ROAD
Mailing Address - Street 2:APT 214
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-4577
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:602 MINERAL PT ROAD
Practice Address - Street 2:APT 214
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-4577
Practice Address - Country:US
Practice Address - Phone:608-273-3961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16257-20207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology