Provider Demographics
NPI:1831406933
Name:NATILI, ANGELIA SMITH (MD)
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:SMITH
Last Name:NATILI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELIA
Other - Middle Name:N
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:707 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-4142
Mailing Address - Country:US
Mailing Address - Phone:704-873-5224
Mailing Address - Fax:
Practice Address - Street 1:707 BRYANT ST
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-4142
Practice Address - Country:US
Practice Address - Phone:704-873-5224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10037973207Y00000X
NC2015-00328207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC0190AMedicare PIN