Provider Demographics
NPI:1942531421
Name:ANGELA N. HUTZENBUHLER MD GASTROENTEROLOGY PA
Entity Type:Organization
Organization Name:ANGELA N. HUTZENBUHLER MD GASTROENTEROLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:N
Authorized Official - Last Name:HUTZENBUHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-788-9060
Mailing Address - Street 1:3200 BLUE RIDGE RD
Mailing Address - Street 2:SUITE 226
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-8086
Mailing Address - Country:US
Mailing Address - Phone:919-788-9060
Mailing Address - Fax:919-861-7748
Practice Address - Street 1:3200 BLUE RIDGE RD
Practice Address - Street 2:SUITE 226
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8086
Practice Address - Country:US
Practice Address - Phone:919-788-9060
Practice Address - Fax:919-861-7748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34994207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty