Provider Demographics
NPI:1992792568
Name:ANG, JOEL C (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:C
Last Name:ANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1759 Q ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2407
Mailing Address - Country:US
Mailing Address - Phone:202-667-5041
Mailing Address - Fax:202-667-0532
Practice Address - Street 1:1759 Q ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2407
Practice Address - Country:US
Practice Address - Phone:202-667-5041
Practice Address - Fax:202-667-0532
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034931207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC038681900Medicaid
2320568OtherUNITED HEALTHCARE
9106822OtherCIGNA
2128349OtherUNITED HEALTHCARE OFTHE MIDATLANTIC (MAMSI)
7738611/041739OtherAETNA
DC0008OtherCAREFIRST OF THE NATIONAL CAPITAL AREA
64233801OtherCAREFIRST OF MARYLAND
7738611/041739OtherAETNA
DCH84370Medicare UPIN