Provider Demographics
NPI:1609879444
Name:BILLUE, ANGELA RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:RENEE
Last Name:BILLUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2934
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24143-2934
Mailing Address - Country:US
Mailing Address - Phone:540-230-7423
Mailing Address - Fax:540-633-0957
Practice Address - Street 1:6785 VISCOE RD
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141-6905
Practice Address - Country:US
Practice Address - Phone:540-230-7423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA84662207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005737460Medicaid
F15245Medicare UPIN
VA005737460Medicaid