Provider Demographics
NPI:1760570527
Name:ANGEL, RICHARD ANDREWS (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ANDREWS
Last Name:ANGEL
Suffix:
Gender:M
Credentials:DO
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2817 REILLY ROAD
Mailing Address - Street 2:WOMACK ARMY MEDICAL CENTER MCXC COD CREDENTIALS
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310
Mailing Address - Country:US
Mailing Address - Phone:910-907-8922
Mailing Address - Fax:910-907-6069
Practice Address - Street 1:2817 REILLY ROAD
Practice Address - Street 2:WOMACK ARMY MEDICAL CENTER MCXC COD CREDENTIALS
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310
Practice Address - Country:US
Practice Address - Phone:910-907-8922
Practice Address - Fax:910-907-6069
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101015214207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine