Provider Demographics
NPI:1386806461
Name:COVINGTON, ANGELA GIRON (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:GIRON
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:MAI-LINH
Other - Last Name:GIRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1103 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2342
Practice Address - Country:US
Practice Address - Phone:406-375-2949
Practice Address - Fax:406-375-4954
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD157885207N00000X
AKMEDS8181207N00000X
MT77094207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1386806461OtherMEDICARE RAILROAD
OR500648663Medicaid
AK1618151Medicaid
ORP01098834OtherMEDICARE RAILROAD
AKP01395059OtherMEDICARE PTAN
AK1386806461OtherMEDICARE RAILROAD
AKP01395059OtherMEDICARE PTAN