Provider Demographics
NPI:1801860515
Name:HARPER, ANGELA DAUBY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:DAUBY
Last Name:HARPER
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 1:1415 BLANDING ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2922
Mailing Address - Country:US
Mailing Address - Phone:803-779-7500
Mailing Address - Fax:803-779-7522
Practice Address - Street 1:1415 BLANDING ST
Practice Address - Street 2:SUITE 4
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2922
Practice Address - Country:US
Practice Address - Phone:803-779-7500
Practice Address - Fax:803-779-7522
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC225442084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
582296052001OtherBCBS PALMETTO HEALTH
SC225447Medicaid
SC400186Medicaid
SC400186Medicaid
SCAA04550281Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID
582296052001OtherBCBS PALMETTO HEALTH