Provider Demographics
NPI:1164541256
Name:SAMBUNARIS, ANGELO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:
Last Name:SAMBUNARIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 N POINT PKWY STE 256
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1174
Mailing Address - Country:US
Mailing Address - Phone:770-817-9200
Mailing Address - Fax:770-817-9201
Practice Address - Street 1:5755 N POINT PKWY STE 256
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1174
Practice Address - Country:US
Practice Address - Phone:770-817-9200
Practice Address - Fax:770-817-9201
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA463212084P0800X
GAGA463212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty