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General NPI Number Information
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NPI Number | 1750383840
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Entity Type | Individual
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Provider Name | ANGELA HARDEN-MACK M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/02/2005
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 3411 WELLNESS WAY STE B1
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City | FINDLAY
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State | OH
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Zip | 45840-9547
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Country | US
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Telephone | 419-423-5344
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 201096
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City | FERNDALE
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State | MI
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Zip | 48220-9096
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Country | US
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Telephone | 540-664-9215
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Fax | 540-536-0061
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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 | 20206
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.152589
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License Number State | OH
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