Healthcare Provider Details

I. General information

NPI: 1457565061
Provider Name (Legal Business Name): MARGARITE MARIE ANGELOPOULOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 CLARK ST
CAMBRIDGE OH
43725-9614
US

IV. Provider business mailing address

951 COMMERCE PKWY SUITE 101
LIMA OH
45804-4040
US

V. Phone/Fax

Practice location:
  • Phone: 407-891-9000
  • Fax:
Mailing address:
  • Phone: 419-998-4575
  • Fax: 419-998-4586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME62647
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number062179
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number062179
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35.080672
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.080672
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: