Provider Demographics
NPI:1295356160
Name:MOUGHNI, ANGELA (DO)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MOUGHNI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-0688
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:14319 DIX TOLEDO RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2506
Practice Address - Country:US
Practice Address - Phone:734-285-0677
Practice Address - Fax:734-285-3574
Is Sole Proprietor?:No
Enumeration Date:2020-05-02
Last Update Date:2023-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101027491207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine