Provider Demographics
NPI:1477632248
Name:ANGERMAIER, GREGORY J (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:ANGERMAIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7720
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19714-7720
Mailing Address - Country:US
Mailing Address - Phone:302-261-6346
Mailing Address - Fax:302-838-2082
Practice Address - Street 1:1220 PEOPLES PLZ
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5701
Practice Address - Country:US
Practice Address - Phone:302-261-6346
Practice Address - Fax:302-838-2082
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000625111N00000X
PADC009507111N00000X
NYX010790111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG02275Medicare ID - Type Unspecified
DE203863626Medicare UPIN