Provider Demographics
NPI:1528246642
Name:PEREZ, ANGEL LUIS JR (MD)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:LUIS
Last Name:PEREZ
Suffix:JR
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 1:3433 N DRUID HILLS RD
Mailing Address - Street 2:APT. H
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3720
Mailing Address - Country:US
Mailing Address - Phone:404-510-1699
Mailing Address - Fax:
Practice Address - Street 1:3110 CLIFTON SPRINGS RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-4600
Practice Address - Country:US
Practice Address - Phone:404-294-3836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA639412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry