Amal A Anga, MD

Key facts

NPI

1629288808

Entity type

Individual (NPI type 1)

Primary specialty

Anatomic Pathology & Clinical Pathology Physician 207ZP0102X

License

41651 (KY)

Practice address

401 Bogle St
Suite 205
Somerset, KY 42503-3823

Phone

(606) 678-3725

NPI assigned

May 23, 2007

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 2, 2010.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1629288808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3727 LOCHDALE TER",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405141754",
            "telephone_number": "859-309-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BOGLE ST",
            "address_2": "SUITE 205",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033823",
            "telephone_number": "606-678-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGA",
        "first_name": "AMAL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "KY",
            "license": "41651",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "41651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07061",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Somerset, KY · Anatomic Pathology & Clinical Pathology Physician in Kentucky