MEDICARE: DR. LUZ 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	208C00000X	Colon & Rectal Surgery Physician	75131	GA

General Provider Information

NPI Number	:	1730250721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUZ ANGEL MD

Provider Business Mailing Address
First Line	:	1800 TREE LN STE 330
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-4700
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 TREE LN STE 330
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-4700
Country	:	US
Telephone Number	:	678-639-3930
Fax Number	:

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	06/19/2025

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Directions to “ DR. LUZ ANGEL MD” Practice Location

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