Provider Demographics
NPI:1558539155
Name:POSTOEV, ANGELINA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELINA
Middle Name:
Last Name:POSTOEV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 ATHENS HWY
Mailing Address - Street 2:BLD 100 SUITE 100A
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-2204
Mailing Address - Country:US
Mailing Address - Phone:678-466-6760
Mailing Address - Fax:678-802-7094
Practice Address - Street 1:367 ATHENS HWY
Practice Address - Street 2:BLD 100 SUITE 100A
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-2204
Practice Address - Country:US
Practice Address - Phone:678-466-6760
Practice Address - Fax:678-802-7094
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA66401208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
202I028169Medicare PIN