Provider Demographics
NPI:1689622516
Name:MUHAMMAD, ANGELA LOUIE (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LOUIE
Last Name:MUHAMMAD
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:P O BOX R
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:39813
Mailing Address - Country:US
Mailing Address - Phone:229-725-4251
Mailing Address - Fax:229-725-2200
Practice Address - Street 1:55 RE JENNINGS AVE SE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:GA
Practice Address - Zip Code:39813-8722
Practice Address - Country:US
Practice Address - Phone:229-725-2147
Practice Address - Fax:229-725-2199
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052291208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
08BBQGPMedicare ID - Type Unspecified
H90325Medicare UPIN