Individual
ANGELOS BASIL VAMVAKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3161 WAYNE DR, DIBERVILLE, MS 39540-8554
(228) 392-2730
Mailing address
3161 WAYNE DR, DIBERVILLE, MS 39540-8554
(228) 392-2730
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
18343
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01080397
—
MS
Enumeration date
07/03/2006
Last updated
02/02/2015
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