Provider Demographics
NPI:1376614156
Name:RING SCARBORO, ANGELA M (PA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:RING SCARBORO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:M
Other - Last Name:RING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6413 WATERS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2711
Mailing Address - Country:US
Mailing Address - Phone:912-349-6624
Mailing Address - Fax:912-352-4728
Practice Address - Street 1:6413 WATERS AVE STE 102
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2711
Practice Address - Country:US
Practice Address - Phone:912-349-6624
Practice Address - Fax:912-352-4728
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4655363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1067109OtherNCCPA
GA226706987AMedicaid
GA97WCGWLOtherMEDICARE PTAN
GA97WCGWLOtherMEDICARE PTAN
GA1067109OtherNCCPA