Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 078409 | GA |
Y | 111NI0900X | Internist | 078409 | GA |
NPI | 1003235060 |
---|---|
Provider Name | Kajal Patel |
First Address | Atlanta, GA 30322-8463 |
Second Address | Atlanta, GA 30322-8463 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 17/03/2018 |