| Angels Medical Associates Llc | |
|
1524 Atwood Ave Suite 327 Johnston RI 02919-3228 | |
| (401) 383-0400 | |
| (401) 383-0410 |
| Full Name | Angels Medical Associates Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1524 Atwood Ave, Johnston, Rhode Island |
| Authorized Official Name and Position | P. Wilfredo Canchis (OWNER) |
| Authorized Official Contact | 4013830400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angels Medical Associates Llc 1524 Atwood Ave Suite 327 Johnston RI 02919-3228 Ph: (401) 383-0400 | Angels Medical Associates Llc 1524 Atwood Ave Suite 327 Johnston RI 02919-3228 Ph: (401) 383-0400 |
| NPI Number | 1922406875 |
|---|---|
| Provider Enumeration Date | 12/09/2014 |
| Last Update Date | 12/18/2014 |
| Medicare PECOS PAC ID | 0446578736 |
|---|---|
| Medicare Enrollment ID | O20150416002406 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922406875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | RI09384 (Rhode Island) | Secondary |
| 207RG0100X | Internal Medicine - Gastroenterology | RI09384 (Rhode Island) | Primary |
| Provider Name | P Wilfredo Canchis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518018811 PECOS PAC ID: 9133225832 Enrollment ID: I20070425000682 |
| Provider Name | Melix Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568124337 PECOS PAC ID: 4284091372 Enrollment ID: I20230605002962 |
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