Angel Brown Boulware
EASTSIDE HEART AND VASCULAR, LLC


Address: 1700 Tree Ln, Suite 190, Snellville, GA 30078-6766
Phone: 7707366300

Angel Brown Boulware (NPI# 1467704429, PAC ID# 1951523935) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.

Physician Overview

Nation Provider ID (NPI) 1467704429
PAC ID by PECOS 1951523935
Professional Enrollment ID I20141106000863
Full Name Angel Brown Boulware
Organization Legal Name EASTSIDE HEART AND VASCULAR, LLC
Address 1700 Tree Ln
Suite 190
Snellville
GA 30078-6766
Phone Number 7707366300
Gender F
Graduation Year 2012
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 1850659376
Number of Group Practice Members 19
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
110087 GWINNETT MEDICAL CENTER

Other Locations

Address Phone Organization
1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694 7709620399 GWINNETT CARDIOLOGY SERVICES LLC
755 Walther Rd, Lawrenceville, GA 30046-8725 7709620399 GWINNETT CARDIOLOGY SERVICES LLC
755 Walther Rd, Suite 130, Lawrenceville, GA 30046-8725 6783281766 GWINNETT CARDIOLOGY SERVICES LLC
1700 Tree Ln, Suite 190, Snellville, GA 30078-6766 7707366300 EASTSIDE HEART AND VASCULAR, LLC

Organization Information

Organization Legal Name EASTSIDE HEART AND VASCULAR, LLC
Physicians 18

Physicians with the same organization

Name Specialty Organization Address
Janet L Whaley Nurse Practitioner Eastside Heart and Vascular, LLC 3435 Hwy 81, Suite 200, Loganville, GA 30052-9138
Demir Baykal Cardiovascular Disease (cardiology) Eastside Heart and Vascular, LLC 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8765
Michael A Lipsitt Cardiovascular Disease (cardiology) Eastside Heart and Vascular, LLC 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694
Berhanu E Kededa Nurse Practitioner Eastside Heart and Vascular, LLC 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694
Halima Mayow Mohamed Nurse Practitioner Eastside Heart and Vascular, LLC 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694
Marc I Unterman Cardiovascular Disease (cardiology) Eastside Heart and Vascular, LLC 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694
Marcus Sims Cardiovascular Disease (cardiology) Eastside Heart and Vascular, LLC 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694
David B Casey Interventional Cardiology Eastside Heart and Vascular, LLC 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8765
Chinwe C Ibiam Nurse Practitioner Eastside Heart and Vascular, LLC 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8765
Claudette Anika Bryant Physician Assistant Eastside Heart and Vascular, LLC 1000 Medical Ctr Blvd, Lawrenceville, GA 30046-7694

Office Location

Street Address 1700 TREE LN
SUITE 190
City SNELLVILLE
State GA
Zip 30078-6766

Physicians in the same location

Name Specialty Organization Address
Nilanee A Karikaran Neurology 1700 Tree Ln, Suite 350, Snellville, GA 30078-6763
Ali Saligheh Araghi Pulmonary Disease 1700 Tree Ln, Suite 160, Snellville, GA 30078-6765
John Stites Urology Georgia Urology, Pa 1700 Tree Ln, Suite 420, Snellville, GA 30078-6745
Katherine H Mawhinney Qualified Audiologist Ear, Nose and Throat Associates, PC 1700 Tree Ln, Suite 320, Snellville, GA 30078-6747
Brett L Woodford Physician Assistant Neurosurgery Atlanta, LLC 1700 Tree Ln, Suite 470, Snellville, GA 30078-6756
Lattisha L Bilbrew Orthopedic Surgery Resurgens, PC 1700 Tree Ln, Suite 300, Snellville, GA 30078-6747
Michael T Stechison Neurosurgery Neurosurgery Atlanta, LLC 1700 Tree Ln, Suite 470, Snellville, GA 30078-6756
Gladys Orwenyo Nurse Practitioner Eastside Heart and Vascular, LLC 1700 Tree Ln, Suite 190, Snellville, GA 30078-6766
Josephine R Dunagan Pediatric Medicine 1700 Tree Ln, Suite 110, Snellville, GA 30078-6749
F D Koch Orthopedic Surgery Resurgens, PC 1700 Tree Ln, Suite 300, Snellville, GA 30078-6747
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Physicians in the same zip code

Name Specialty Organization Address
Ashley Ann Mire Certified Registered Nurse Anesthetist (crna) Premier Anesthesia of Georgia LLC 1700 Medical Ctr Way, Snellville, GA 30078
Ramanjaneyulu V Dronavalli Internal Medicine 2138 Scenic N Hwy A, Snellville, GA 30078
Jody Meek Anesthesiology Assistant Premier Anesthesia of Georgia LLC 1700 Medical Ctr Way, Snellville, GA 30078
Brittany E Bradley Certified Registered Nurse Anesthetist (crna) Premier Anesthesia of Georgia LLC 1700 Medical Ctr Way, Snellville, GA 30078
Keith Alan Housman Anesthesiology Premier Anesthesia of Georgia LLC 1700 Medical Ctr Way, Snellville, GA 30078
Thien D Quach Anesthesiology Premier Anesthesia of Georgia LLC 1700 Medical Ctr Way, Snellville, GA 30078
Benjamin Lee Hicks Anesthesiology Assistant Premier Anesthesia of Georgia LLC 1700 Medical Ctr Way, Snellville, GA 30078
Geetha Jonnala Rheumatology 1567 Janmar Rd, Suite 100, Snellville, GA 30078-0308
Oyinkansola Akinmade Physical Therapy Caretherapy, LLC 1567 Janmar Rd, Snellville, GA 30078-0309
Allison L Guisasola Occupational Therapy Caretherapy, LLC 1567 Janmar Rd, Snellville, GA 30078-0309
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Competitor

Search similar physicians

City SNELLVILLE
Zip Code 30078
Specialty NURSE PRACTITIONER
City + Specialty SNELLVILLE + NURSE PRACTITIONER

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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