Provider Demographics
NPI:1932314580
Name:ROSEMARY M AQUILER ANGELES MD PC
Entity Type:Organization
Organization Name:ROSEMARY M AQUILER ANGELES MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:AQUILER ANGELES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-426-0110
Mailing Address - Street 1:18829 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3262
Mailing Address - Country:US
Mailing Address - Phone:248-426-0110
Mailing Address - Fax:248-426-0220
Practice Address - Street 1:18829 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3262
Practice Address - Country:US
Practice Address - Phone:248-426-0110
Practice Address - Fax:248-426-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRA067645207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI101177OtherGREAT LAKES HEALTH PLAN
MI130515OtherTRINITY HEALTH PLANS
MI23D0975555OtherCLIA
MI110H232750OtherBCBSM
MI900042060OtherPRIORITY HEALTH
MI7061OtherTOTAL HEALTH CARE
MI7061OtherTOTAL HEALTH CARE
MI900042060OtherPRIORITY HEALTH
MIBA6436162OtherDEA