MEDICARE: DR. HERBERT ANG 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	207R00000X	Internal Medicine Physician	57694	MA
2	207RR0500X	Rheumatology Physician	57694	MA

General Provider Information

NPI Number	:	1598754798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERBERT ANG M.D.

Provider Business Mailing Address
First Line	:	37 BROADWAY
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02474-5552
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	37 BROADWAY
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02474-5552
Country	:	US
Telephone Number	:	781-641-0100
Fax Number	:

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	07/16/2007

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