Provider Demographics
NPI:1740351147
Name:ANGELO, JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:ANGELO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 PLUMTREE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6056
Mailing Address - Country:US
Mailing Address - Phone:410-588-5681
Mailing Address - Fax:410-588-5682
Practice Address - Street 1:208 PLUMTREE RD
Practice Address - Street 2:SUITE D
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6056
Practice Address - Country:US
Practice Address - Phone:410-588-5681
Practice Address - Fax:410-588-5682
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD56607207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00174633OtherRAILROAD
G34428Medicare UPIN
057N 903FMedicare PIN