Healthcare Provider Details

I. General information

NPI: 1447437868
Provider Name (Legal Business Name): ANGELA J OATES M.D,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 OMEGA DR BLDG C
NEWARK DE
19713-2064
US

IV. Provider business mailing address

78 OMEGA DR BLDG C
NEWARK DE
19713-2064
US

V. Phone/Fax

Practice location:
  • Phone: 302-368-2883
  • Fax: 302-368-2892
Mailing address:
  • Phone: 302-368-2883
  • Fax: 302-368-2892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MA08802300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD440140
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberC10024910
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: