Provider Demographics
NPI:1407251259
Name:KORB, ANGELA G (MS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:G
Last Name:KORB
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5422
Mailing Address - Country:US
Mailing Address - Phone:800-749-5191
Mailing Address - Fax:410-630-7685
Practice Address - Street 1:106 MILFORD ST STE 605
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6938
Practice Address - Country:US
Practice Address - Phone:410-334-2227
Practice Address - Fax:410-334-6451
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05581363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical