Healthcare Provider Details

I. General information

NPI: 1124206388
Provider Name (Legal Business Name): ANGELA HAWKES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 08/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 HORSE PEN CREEK RD SUITE 101
GREENSBORO NC
27410-9700
US

IV. Provider business mailing address

2835 HORSE PEN CREEK RD SUITE 101
GREENSBORO NC
27410-9700
US

V. Phone/Fax

Practice location:
  • Phone: 336-617-6568
  • Fax: 336-617-6660
Mailing address:
  • Phone: 336-617-6568
  • Fax: 336-617-6660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD036609
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number2010-00331
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: