Basic Information
| Provider Information | |||||||||
| NPI: | 1003858051 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOWARD | ||||||||
| FirstName: | ANGUS | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 595 HURRICANE SHOALS RD NW STE 100 | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300468762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046457150 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 595 HURRICANE SHOALS RD NW STE 100 | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046457150 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2006 | ||||||||
| LastUpdateDate: | 05/31/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 030099 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 000470401C | 05 | GA | MEDICAID | 000470401F | 05 | GA | MEDICAID | 000470401H | 05 | GA | MEDICAID | 1634458 | 01 | GA | CIGNA | OTHER | 000470401G | 05 | GA | MEDICAID | 110051099 | 01 | RAILROAD MEDICARE | OTHER | 000470401E | 05 | GA | MEDICAID | 3106162 | 01 | GA | UNITED HEALTH CARE | OTHER | 000470401A | 05 | GA | MEDICAID | 28257 | 01 | GA | BCBS | OTHER | 505559 | 01 | GA | AETNA | OTHER | 000470401D | 05 | GA | MEDICAID | 000470401I | 05 | GA | MEDICAID | 000470401K | 05 | GA | MEDICAID | 000470401O | 05 | GA | MEDICAID | 000470401Q | 05 | GA | MEDICAID |