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General NPI Number Information
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NPI Number | 1689671190
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Entity Type | Individual
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Provider Name | CARMICHAEL ANGELES M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 2500 ROUTE 347 BLDG 14A
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City | STONY BROOK
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State | NY
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Zip | 11790-2554
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Country | US
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Telephone | 631-689-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 ROUTE 347 BLDG 14A
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City | STONY BROOK
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State | NY
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Zip | 11790-2554
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Country | US
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Telephone | 631-689-7800
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 2255725
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License Number State | NY
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