Provider Demographics
NPI:1881352557
Name:ANGELES, DAVID D (CPT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:D
Last Name:ANGELES
Suffix:
Gender:M
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 AUCHENTOROLY TER APT 2F
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-1954
Mailing Address - Country:US
Mailing Address - Phone:240-482-7510
Mailing Address - Fax:240-712-5999
Practice Address - Street 1:3200 AUCHENTOROLY TER APT 2F
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-1954
Practice Address - Country:US
Practice Address - Phone:240-482-7510
Practice Address - Fax:240-712-5999
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2135270261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation