Individual
MICHAEL ALON ANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 CHINABERRY DR STE 800, BOSSIER CITY, LA 71111-2455
(318) 392-3372
(318) 392-3373
Mailing address
4438 VIKING DR STE 300, BOSSIER CITY, LA 71111-7510
(318) 918-0015
(318) 963-0015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
025219
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1486434
—
LA
Enumeration date
10/07/2005
Last updated
04/17/2024
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