Provider Demographics
NPI:1366458622
Name:ANGLEMEYER, ANDREW P (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:P
Last Name:ANGLEMEYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 S MAIN STREET
Mailing Address - Street 2:P O BOX 539
Mailing Address - City:MILFORD
Mailing Address - State:IN
Mailing Address - Zip Code:46542
Mailing Address - Country:US
Mailing Address - Phone:574-658-3500
Mailing Address - Fax:574-658-3501
Practice Address - Street 1:112 S MAIN STREET
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:IN
Practice Address - Zip Code:46542
Practice Address - Country:US
Practice Address - Phone:574-658-3500
Practice Address - Fax:574-658-3501
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02000985A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100427870CMedicaid
IN262490DDMedicare PIN
INB28652Medicare UPIN
IN100427870CMedicaid
453220HMedicare PIN