Individual
RICHARD JOHN DEANGELIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1409 N FANT ST, ANDERSON, SC 29621-4825
(864) 231-8599
(864) 231-8073
Mailing address
1409 N FANT ST, ANDERSON, SC 29621-4825
(864) 231-8599
(864) 231-8073
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
15293
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TL2726
—
SC
Enumeration date
08/09/2005
Last updated
07/08/2007
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