Provider Demographics
NPI:1689741126
Name:DAVIS, ANGELA (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:DAVIS
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:GLAXO-SMITH-KLINE
Mailing Address - Street 2:5 MOORE DRIVE 17-1315G
Mailing Address - City:RTP
Mailing Address - State:NC
Mailing Address - Zip Code:27709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-2835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-01288207RP1001X, 207RA0201X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Not Answered207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2291035Medicare ID - Type Unspecified
NC89129U4Medicare ID - Type Unspecified
H43752Medicare ID - Type Unspecified