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General NPI Number Information
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NPI Number | 1477509354
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Entity Type | Individual
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Provider Name | ANGELA L. HOLLIS MD
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Gender | Female
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 2411 WILMINGTON RD
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City | NEW CASTLE
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State | PA
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Zip | 16105-1938
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Country | US
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Telephone | 724-656-4320
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Fax | 724-656-4324
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Provider Business Mailing Address
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Address Line | 2411 WILMINGTON RD
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City | NEW CASTLE
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State | PA
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Zip | 16105-1938
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Country | US
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Telephone | 724-656-4320
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Fax | 724-656-4324
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD428318
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 28679
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License Number State | SC
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