Organization Active NPI

Dora Anguelova, MD, PHD, PA

  • Specialist
  • Murrells Inlet, SC
National Provider Identifier
1528022845
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DORA ANGUELOVA, MD, PHD, PA
Practice address
4914 Highway 17
Murrells Inlet, SC 29576-5040
Phone
(843) 357-6734
Fax
(843) 357-6770
NPI assigned
Apr 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ivo Anguelov, MDNPI 1295798031
Title
Manager
Phone
(843) 357-6734

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

4914 Highway 17
Murrells Inlet, SC 29576-5040

Mailing address

PO Box 749
Murrells Inlet, SC 29576-0749
Phone (843) 357-6734

Other identifiers 1

IdentifierTypeStateIssuer
GP 3580MedicaidSC

Other names 1

  • magnolia general medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000722 SC Part B Supplier - Clinic/Group Practice 2163336454 Receives reassigned benefits from 2 practitioners
Practice locations: Murrells Inlet, SC

National Provider Directory

National Provider Directory

Locations

4914 Highway 17
Murrells Inlt, SC 29576
Phone (843) 357-6734

675 Wachesaw Rd
Unit A
Murrells Inlt, SC 29576
Phone (843) 357-6734

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1528022845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295760749",
            "telephone_number": "843-357-6734",
            "fax_number": "843-357-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 HIGHWAY 17",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765040",
            "telephone_number": "843-357-6734",
            "fax_number": "843-357-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DORA ANGUELOVA, MD, PHD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2010-02-08",
        "status": "A",
        "authorized_official_last_name": "ANGUELOV",
        "authorized_official_first_name": "IVO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "843-357-6734",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP 3580",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "magnolia general medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murrells Inlet, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.