Individual
DR. JELLA ANGELA AN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
ONE HOSPITAL DRIVE, COLUMBIA, MO 65212-0001
(573) 882-1506
(573) 884-5575
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
2016008029
MO
207W00000X
Ophthalmology Physician
Primary
D92510
MD
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
2016008029
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D92510
MD LICENSE
MD
Enumeration date
06/03/2016
Last updated
04/27/2022
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