Individual
ANDREW ANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40 HOLLAND ST, INTERNAL MEDICINE, SOMERVILLE, MA 02144-2705
(617) 629-6350
(617) 629-6067
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
160093
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3204812
—
MA
01
—
404171
TUFTS
MA
01
—
HV0052
HARVARD PILGRIM
MA
01
—
J21916
BLUE CROSS
MA
Enumeration date
01/26/2006
Last updated
10/21/2020
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