Provider Demographics
NPI:1497954069
Name:JOEL C. ANG, MD, PC
Entity type:Organization
Organization Name:JOEL C. ANG, MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:W
Authorized Official - Last Name:SCHICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-667-5041
Mailing Address - Street 1:1759 Q ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2407
Mailing Address - Country:US
Mailing Address - Phone:202-667-5041
Mailing Address - Fax:202-667-0532
Practice Address - Street 1:1759 Q ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2407
Practice Address - Country:US
Practice Address - Phone:202-667-5041
Practice Address - Fax:202-667-0532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC038681900Medicaid
DC011068900Medicaid
DC718284Medicare PIN