Provider Demographics
NPI:1639388671
Name:WILLIAMS, ANGELA G (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:G
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10 N GREENE ST
Mailing Address - Street 2:6C-113
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1524
Mailing Address - Country:US
Mailing Address - Phone:410-605-7111
Mailing Address - Fax:410-605-7777
Practice Address - Street 1:10 N GREENE ST
Practice Address - Street 2:6C-113
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1524
Practice Address - Country:US
Practice Address - Phone:410-605-7111
Practice Address - Fax:410-605-7777
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDC0000943363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant