Provider Demographics
NPI:1891723086
Name:IGLESIAS, ANGEL (MD PHD)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:IGLESIAS
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-364-7000
Mailing Address - Fax:
Practice Address - Street 1:2525 CUMBERLAND PKWY SE DEPT OF
Practice Address - Street 2:KAISER PERMANENTE CUMBERLAND MEDICAL CENTER
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3915
Practice Address - Country:US
Practice Address - Phone:770-431-4149
Practice Address - Fax:770-431-4388
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA049035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine