Jacob, Angela Renee

Jacob, Angela Renee is an sole proprietor health care provider with primary practice located at 6900 Orchard Lake Rd Ste 207 , West Bloomfield MI 48322-3425. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as her primary health care specialty. Jacob, Angela Renee can be contacted via phone (248) 963-0919.

Contact Information

Primary practice address
6900 Orchard Lake Rd Ste 207 West Bloomfield MI 48322-3425
Phone: (248) 963-0919
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 5315080074 Michigan
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 5901002584 Michigan

Profile Details

NPI number 1124430806
LBN Legal business name Jacob, Angela Renee
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 29th, 2014
Last updated Jun 15th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124430806 NPPES
Michigan MEDICAID 1124430806

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