Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 064436 | GA |
NPI | 1023194180 |
---|---|
Provider Name | Kapil Pareek |
First Address | Atlanta, GA 30374-2616 |
Second Address | Braselton, GA 30517-5600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 23/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202I341839 | MEDICARE PTAN (01) | GA |
350577884A | (05) | GA |