Healthcare Provider Details

I. General information

NPI: 1841272986
Provider Name (Legal Business Name): ELIZABETH GILBERT D'ANGELO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 NEWMAN RD
NEW BERN NC
28562-5238
US

IV. Provider business mailing address

722 NEWMAN RD
NEW BERN NC
28562-5238
US

V. Phone/Fax

Practice location:
  • Phone: 252-633-5057
  • Fax: 252-633-0084
Mailing address:
  • Phone: 252-633-5057
  • Fax: 252-633-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number9701307
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number9701307
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number9701307
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number9701307
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number9701307
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number9701307
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number9701307
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number9701307
License Number StateNC
# 9
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number9701307
License Number StateNC
# 10
Primary TaxonomyN
Taxonomy Code2085R0205X
TaxonomyRadiological Physics Physician
License Number9701307
License Number StateNC
# 11
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number9701307
License Number StateNC
# 12
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number9701307
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: