MEDICARE: DR. SERGIO ESTEBAN ANGEL MD

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	207Q00000X	Family Medicine Physician	96937	GA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1346878261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SERGIO ESTEBAN ANGEL MD

Provider Business Mailing Address
First Line	:	3640 MUNDY MILL RD STE 112
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30504-8201
Country	:	US
Telephone Number	:	877-549-4633
Fax Number	:	678-968-7739

Provider Business Practice Location Address
First Line	:	3455 PEACHTREE RD NE FL 5
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-3254
Country	:	US
Telephone Number	:	877-549-4633
Fax Number	:	678-968-7739

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

Provider Enumeration Date	:	03/27/2020
Last Update Date	:	02/09/2026

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