MEDICARE: DR. ANGELA KAY LOUIE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	25MA08028500	NJ
2	2084P0800X	Psychiatry Physician	2007-01826	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	232009	OTHER	NC	PTAN MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	2007-01826	OTHER	NC	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1275697286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELA KAY LOUIE M.D.

Provider Business Mailing Address
First Line	:	3535 WEDDINGTON OAKS
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28104-9542
Country	:	US
Telephone Number	:	201-674-4696
Fax Number	:	919-573-9696

Provider Business Practice Location Address
First Line	:	6845 FAIRVIEW RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-3363
Country	:	US
Telephone Number	:	980-819-1807
Fax Number	:	919-573-9696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	02/22/2022

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Directions to “ DR. ANGELA KAY LOUIE M.D.” Practice Location

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