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General NPI Number Information
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NPI Number | 1265571285
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Entity Type | Individual
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Provider Name | ANGELA DOUGLAS MD
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | UNM SOM MSC08 4720 1 UNM
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-3536
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Country | US
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Telephone | 505-272-2321
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Fax |
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Provider Business Mailing Address
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Address Line | 800 BRADBURY DR SE STE 116
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD177110
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | MD34080
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | MD2009-0679
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD2009-0679
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License Number State | NM
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