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NPI Code Detail

MEDICARE: DR. ANGELA IMPERIAL HOWDESHELL MD

MEDICARE: DR. ANGELA IMPERIAL HOWDESHELL MD
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
12084P0800XPsychiatry PhysicianWY2103AWY
22084P0800XPsychiatry Physician0798SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1305054OTHERWYBS

General Provider Information

NPI Number : 1760463988
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA IMPERIAL HOWDESHELL MD
Provider Business Mailing Address
First Line : PO BOX 1005
Second Line :
City : CHEYENNE
State : WY
Zip : 82003-1005
Country : US
Telephone Number : 307-634-9653
Fax Number : 307-638-8256
Provider Business Practice Location Address
First Line : 1263 N 15TH ST
Second Line : PEAK WELLNESS CENTER- ALBANY BRANCH
City : LARAMIE
State : WY
Zip : 82072-2343
Country : US
Telephone Number : 307-745-8915
Fax Number : 307-745-8761
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2005
Last Update Date : 07/08/2007

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