Provider Demographics
NPI:1851451918
Name:SAMPANG, VIRGINIA ANGELES (MD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:ANGELES
Last Name:SAMPANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:A
Other - Last Name:ANGELES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:MC CA410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:717-531-5814
Mailing Address - Fax:717-531-0494
Practice Address - Street 1:32 COLONNADE WAY
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-2309
Practice Address - Country:US
Practice Address - Phone:717-531-5164
Practice Address - Fax:717-531-0646
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240284207Q00000X
PAMD480216207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV1385AMedicare PIN
VA021215YWAUMedicare PIN