Individual
PRODROMOS MIKE ANGELIDIS
Active
Individual
PRODROMOS MIKE ANGELIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23934
OK
207R00000X
Internal Medicine Physician
N0610
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198836201
—
TX
05
—
198836202
—
TX
05
—
198836203
—
TX
Enumeration date
02/07/2007
Last updated
03/15/2012
Update your record
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