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General NPI Number Information
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NPI Number | 1962584490
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Entity Type | Individual
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Provider Name | JOSEPH ANGOTT
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Gender | Male
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 04/17/2015
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Provider Practice Location Address
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Address Line | 22101 MOROSS RD
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City | DETROIT
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State | MI
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Zip | 48236-2148
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Country | US
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Telephone | 313-642-9809
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Fax |
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Provider Business Mailing Address
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Address Line | 832 HIDDEN LN
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City | GROSSE POINTE WOODS
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State | MI
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Zip | 48236-1522
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Country | US
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Telephone | 313-377-9668
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704188673
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License Number State | MI
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