Individual
ANGELO DIFELICE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1285 HEMBREE RD, STE 200A, ROSWELL, GA 30076
(770) 475-2710
(770) 360-0498
Mailing address
1285 HEMBREE RD, STE 200A, ROSWELL, GA 30076
(770) 475-2710
(770) 360-0498
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
039324
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
442438630C
—
GA
05
—
442438630D
—
GA
05
—
442438630E
—
GA
05
—
442438630F
—
GA
05
—
442438630G
—
GA
Enumeration date
07/28/2005
Last updated
06/22/2016
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