MEDICARE: DR. ANGELA MICHELLE CULBRETH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD037786	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00044287	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2708513	OTHER	TN	CIGNA
4	27418	OTHER	TN	TLC
5	145990	OTHER	TN	UNISON
7	626001636	OTHER	TN	HEALTH NOW
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	4064661	OTHER	TN	BLUE CROSS BLUE SHIELD
10	626001636	OTHER	TN	USA MANAGED CARE
11	626001636	OTHER	TN	BHSG
12	557903	OTHER	TN	UAHC
13	626001636	OTHER	TN	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1558358788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELA MICHELLE CULBRETH M.D.

Provider Business Mailing Address
First Line	:	2961 CANADA RD STE 105
Second Line	:
City	:	LAKELAND
State	:	TN
Zip	:	38002-4893
Country	:	US
Telephone Number	:	901-388-0115
Fax Number	:	19-385-7924

Provider Business Practice Location Address
First Line	:	2961 CANADA RD STE 105
Second Line	:
City	:	LAKELAND
State	:	TN
Zip	:	38002-4893
Country	:	US
Telephone Number	:	901-388-0115
Fax Number	:	901-385-7924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	05/18/2022

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Directions to “ DR. ANGELA MICHELLE CULBRETH M.D.” Practice Location

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