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Individual

MICHAEL ALEX DEANGELIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-5030
(215) 707-3494
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-5030
(215) 707-3494

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD422941
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1012133930003
PA
01
1653754
HIGHMARK BS
PA
01
2330394000
INDEPENDENCE BC
PA
Enumeration date
03/14/2006
Last updated
03/21/2017
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