Lake, Angel Anthony

Lake, Angel Anthony is an sole proprietor health care provider with primary practice located at 4007 Diamond Ruby , Christiansted VI 00820. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Lake, Angel Anthony can be contacted via phone (340) 778-6311.

Contact Information

Primary practice address
4007 Diamond Ruby Christiansted VI 00820
Phone: (340) 778-6311
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 1365 Virgin Islands

Profile Details

NPI number 1205978335
LBN Legal business name Lake, Angel Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2007
Last updated Aug 26th, 2010 - about 15 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 1205978335 NPPES
Virgin Islands Other 1365 VI LIC NUMBER

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