Individual
CHARLES DOUGLAS ANGEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
106 HULBURT RD, FAIRPORT, NY 14450-2464
(585) 377-8009
Mailing address
106 HULBURT RD, FAIRPORT, NY 14450-2464
(585) 377-8009
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
103318-1
NY
207RR0500X
Rheumatology Physician
16464-020
WI
Other
Enumeration date
05/29/2009
Last updated
05/29/2009
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