Provider Demographics
NPI:1407932049
Name:RAPOSAS, ANGEL Q (MD)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:Q
Last Name:RAPOSAS
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 1:3552 WOODSIDE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-5258
Mailing Address - Country:US
Mailing Address - Phone:814-693-1024
Mailing Address - Fax:814-941-3445
Practice Address - Street 1:501 HOWARD AVENUE
Practice Address - Street 2:STE D101
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601
Practice Address - Country:US
Practice Address - Phone:814-941-3005
Practice Address - Fax:814-941-3445
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059783L207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018116200001Medicaid
H21772Medicare UPIN
PA0018116200001Medicaid