Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 60548 | GA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 60548 | GA |
NPI | 1295725463 |
---|---|
Provider Name | Anshul Mahendra Patel |
First Address | Atlanta, GA 30342-1786 |
Second Address | Atlanta, GA 30342-1786 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 19/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
366826914A | (05) | GA |
H69666 | (02) |