Stephen T Ang Md Sc | |
1054 Martin Luther King Dr Ste 120 Centralia IL 62801-3000 | |
(618) 532-1688 | |
(618) 436-8081 |
Full Name | Stephen T Ang Md Sc |
---|---|
Speciality | Internal Medicine |
Location | 1054 Martin Luther King Dr, Centralia, Illinois |
Authorized Official Name and Position | Stephen Ang (PHYSICIAN) |
Authorized Official Contact | 6185321688 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Stephen T Ang Md Sc 1054 Martin Luther King Dr Ste 120 Centralia IL 62801-3000 Ph: (618) 532-1688 | Stephen T Ang Md Sc 1054 Martin Luther King Dr Ste 120 Centralia IL 62801-3000 Ph: (618) 532-1688 |
NPI Number | 1427331891 |
---|---|
Provider Enumeration Date | 09/22/2011 |
Last Update Date | 10/27/2011 |
Medicare PECOS PAC ID | 8123292091 |
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Medicare Enrollment ID | O20111111000254 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427331891 | NPI | - | NPPES |
036088477 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | Stephen T Ang |
---|---|
Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1346251071 PECOS PAC ID: 1254370448 Enrollment ID: I20050427000717 |
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