Provider Demographics
NPI:1689693533
Name:SUGGS, ANGELO L (PT)
Entity Type:Individual
Prefix:MR
First Name:ANGELO
Middle Name:L
Last Name:SUGGS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 HARDY CASH DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2400
Mailing Address - Country:US
Mailing Address - Phone:757-838-7453
Mailing Address - Fax:757-838-2314
Practice Address - Street 1:1618 HARDY CASH DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2400
Practice Address - Country:US
Practice Address - Phone:757-838-7453
Practice Address - Fax:757-838-2314
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305001701225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA416230OtherMAMSI
VA541326404-0005OtherTRICARE
VA0004601344OtherAETNA
VA331449OtherTRIGON BLUE CROSS BLUE SH
VA416230OtherMAMSI