Individual
JOHN EDWARD ANGELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1970 N HIGHWAY 190, COVINGTON, LA 70433-5364
(985) 705-9020
(844) 272-9196
Mailing address
76409 CROCKETT RD, FOLSOM, LA 70437-3718
(985) 705-3979
(844) 272-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
014342
LA
207RN0300X
Nephrology Physician
Primary
014342
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1314650
—
LA
Enumeration date
12/02/2005
Last updated
02/20/2023
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