Provider Demographics
NPI:1982043014
Name:DE HAMER, ANGELA (DO)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:DE HAMER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:KALIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-247-4240
Mailing Address - Fax:515-247-4239
Practice Address - Street 1:1111 6TH AVE FL 4
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-2610
Practice Address - Country:US
Practice Address - Phone:515-247-4240
Practice Address - Fax:515-247-4239
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020708207Q00000X
CODR.0057686207R00000X
IADO-05393208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine