Subauste, Angela R

Subauste, Angela R is an individual health care provider with primary practice located at 2500 North State Street , Jackson MS 39216. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism. Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism is her primary health care specialty. Subauste, Angela R can be contacted via phone (601) 984-5525.

Contact Information

Primary practice address
2500 North State Street Jackson MS 39216
Phone: (601) 984-5525
Fax: (601) 984-6439
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301080359 Michigan
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 4301080359 Michigan
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 22041 Mississippi

Profile Details

NPI number 1194808030
LBN Legal business name Subauste, Angela R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Apr 9th, 2014 - about 12 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 1194808030 NPPES
Michigan MEDICAID 4641855
Michigan MEDICAID 09232094

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