Individual
ANGELO SO ANTARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5301 E HURON RIVER DR, YPSILANTI, MI 48197-1051
(734) 712-5609
(734) 712-5797
Mailing address
5301 E HURON RIVER DR, YPSILANTI, MI 48197-1051
(734) 712-5609
(734) 712-5797
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601003519
MI
Other
Enumeration date
06/30/2005
Last updated
07/09/2007
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