Individual
ANGELA MAYO HINNENKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
001000160
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611186890
FEDERAL TAX ID#
NC
Enumeration date
10/02/2006
Last updated
11/12/2009
Update your record
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