Individual
DR. CARMICHAEL ANGELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 ROUTE 347, BLDG 14A, STONY BROOK, NY 11790-2554
(631) 689-7800
Mailing address
2500 ROUTE 347, BLDG 14A, STONY BROOK, NY 11790-2554
(631) 689-7800
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
2255725
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02410768
—
NY
01
—
148301
VYTRA
NY
01
—
6X8591
EMPIRE BLUECROSS BLUESHIE
NY
01
—
P00073812
MEDICARE RAILROAD
NY
01
—
P2949859
OXFORD
NY
Enumeration date
06/30/2005
Last updated
01/03/2012
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