Provider Demographics
NPI:1952373441
Name:ANGELL, DONNA (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:ANGELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7445 ALLEN RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1963
Mailing Address - Country:US
Mailing Address - Phone:313-386-5500
Mailing Address - Fax:313-386-3444
Practice Address - Street 1:7445 ALLEN RD
Practice Address - Street 2:SUITE 250
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1963
Practice Address - Country:US
Practice Address - Phone:313-386-5500
Practice Address - Fax:313-386-3444
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301049818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4545053Medicaid
MIE38125Medicare UPIN
MI4545053Medicaid