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General NPI Number Information
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NPI Number | 1275693772
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Entity Type | Individual
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Provider Name | DEBORAH S WOOTEN-ANGELO M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/29/2016
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Provider Practice Location Address
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Address Line | 101 COURT ST 4TH FLOOR UNIT 8
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City | PLYMOUTH
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State | MA
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Zip | 02360-8718
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Country | US
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Telephone | 508-732-7327
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Fax | 508-746-1958
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Provider Business Mailing Address
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Address Line | 101 COURT ST 4TH FLOOR UNIT 8
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City | PLYMOUTH
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State | MA
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Zip | 02360-8718
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Country | US
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Telephone | 508-732-7327
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Fax | 508-746-1958
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 79071
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License Number State | MA
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