MEDICARE: MICHAEL ANGERBAUER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	0101286037	VA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1326788050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ANGERBAUER

Provider Business Mailing Address
First Line	:	213 S JEFFERSON ST STE 1006
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24011-1713
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4035 ELECTRIC RD STE A
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-8449
Country	:	US
Telephone Number	:	540-772-8670
Fax Number	:	540-772-7901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	01/26/2026

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Directions to “ MICHAEL ANGERBAUER ” Practice Location

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