Provider Demographics
NPI:1316130206
Name:ANGELINA, ADLA (MD)
Entity type:Individual
Prefix:DR
First Name:ADLA
Middle Name:
Last Name:ANGELINA
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 1:3003 E 3RD AVE # B110-I
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5110
Mailing Address - Country:US
Mailing Address - Phone:303-630-9412
Mailing Address - Fax:
Practice Address - Street 1:3003 E 3RD AVE # B110-I
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5110
Practice Address - Country:US
Practice Address - Phone:303-630-9412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0060843207ZB0001X, 207ZC0006X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology