Provider Demographics
NPI:1407251259
Name:KORB, ANGELA G (MS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:G
Last Name:KORB
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1344 S DIVISION ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-7096
Mailing Address - Country:US
Mailing Address - Phone:443-614-4105
Mailing Address - Fax:443-397-9888
Practice Address - Street 1:1344 S DIVISION ST STE 202
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-7096
Practice Address - Country:US
Practice Address - Phone:443-614-4105
Practice Address - Fax:443-397-9888
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05581363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical