Provider Demographics
NPI:1669739041
Name:MCGRADY, ANGELA LUCILLE (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LUCILLE
Last Name:MCGRADY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 FLETCHER ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-1050
Mailing Address - Country:US
Mailing Address - Phone:734-764-8320
Mailing Address - Fax:
Practice Address - Street 1:207 FLETCHER ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1050
Practice Address - Country:US
Practice Address - Phone:734-764-8320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101258710207Q00000X
MI4301109212207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine