Provider Demographics
NPI:1538331939
Name:VANLANDINGHAM, ANGELA ROSE (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ROSE
Last Name:VANLANDINGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:ROSE
Other - Last Name:COCHRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7202 GLEN FOREST DR.,
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3780
Mailing Address - Country:US
Mailing Address - Phone:804-673-2024
Mailing Address - Fax:804-673-1796
Practice Address - Street 1:7501 RIGHT FLANK RD STE 600
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3863
Practice Address - Country:US
Practice Address - Phone:804-559-2489
Practice Address - Fax:804-730-5847
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101259011207RH0003X
390200000X
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2951002OtherCIGNA
KYK015521Medicare PIN
IN201041360OtherMEDICAID - NICC
KYP01003167Medicare PIN
KY7100133690Medicaid