Provider Demographics
NPI:1174567986
Name:D'ANGELO, WILLIAM F (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:F
Last Name:D'ANGELO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:301 US ROUTE 1
Mailing Address - Street 2:BUILDING C
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7609
Mailing Address - Country:US
Mailing Address - Phone:207-396-8600
Mailing Address - Fax:207-396-8632
Practice Address - Street 1:49 SPRING ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-8926
Practice Address - Country:US
Practice Address - Phone:207-885-4479
Practice Address - Fax:207-883-2586
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2013-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEMD11763207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME285650099Medicaid
NH00001011Medicaid
MEP00456798Medicare PIN
MEB86639Medicare UPIN
NH00001011Medicaid
ME015577Medicare PIN
ME01557702Medicare PIN
ME01557701Medicare PIN
ME01557703Medicare PIN