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Contact Information

ANGELO DIFELICE JR
1285 HEMBREE RD
STE 200A
ROSWELL, GA30076
 Phone: 770-475-2710
 Fax: 770-360-0498
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for ANGELO DIFELICE JR · (Male)

NPI Number 1861492274
Status Active
Credentials
Entity Individual
Enumeration date 07/28/2005
Last updated 06/22/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 039324
  • GA Medicaid 442438630C
  • GA Medicaid 442438630D
  • GA Medicaid 442438630E
  • GA Medicaid 442438630F
  • GA Medicaid 442438630G
Hospital affiliation(s)
  • NORTH FULTON REGIONAL HOSPITAL - (Acute Care)
    3000 HOSPITAL BOULEVARD
    ROSWELL, GA 30076
  • NORTHSIDE HOSPITAL FORSYTH - (Acute Care)
    1200 NORTHSIDE FORSYTH DRIVE
    CUMMING, GA 30041
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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