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NPI Code Detail

MEDICARE: DEANINE M ANGOTTI PA

MEDICARE: DEANINE M ANGOTTI PA
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
1363AM0700XMedical Physician Assistant
2363A00000XPhysician Assistant10933GA
3363AM0700XMedical Physician Assistant10933GA

General Provider Information

NPI Number : 1992705131
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANINE M ANGOTTI PA
Provider Business Mailing Address
First Line : PO BOX 742616
Second Line :
City : ATLANTA
State : GA
Zip : 30374-2616
Country : US
Telephone Number : 770-282-8820
Fax Number :
Provider Business Practice Location Address
First Line : 743 SPRING ST NE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3715
Country : US
Telephone Number : 770-219-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 12/08/2025

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Directions to “ DEANINE M ANGOTTI PA” Practice Location

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