Provider Demographics
NPI:1386727378
Name:CAMPBELL, ANGELA JP (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:JP
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:J
Other - Last Name:PECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 CLIFTON RD NE
Mailing Address - Street 2:MAILSTOP A32
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-4018
Mailing Address - Country:US
Mailing Address - Phone:404-639-3376
Mailing Address - Fax:404-639-3866
Practice Address - Street 1:1600 CLIFTON RD NE
Practice Address - Street 2:MAILSTOP A32
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-4018
Practice Address - Country:US
Practice Address - Phone:404-639-3376
Practice Address - Fax:404-639-3866
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000402062080P0208X
GA703532080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases