Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 080360 | GA |
N | 2080P0216X | Pediatric Rheumatologist | 2012-01786 | NC |
NPI | 1205096336 |
---|---|
Provider Name | Julisa Margarita Patel |
First Address | Augusta, GA 30912-0004 |
Second Address | Augusta, GA 30912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 22/06/2018 |