Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | GA26928 | GA |
NPI | 1043364862 |
---|---|
Provider Name | Navinchandra M Ruparelia |
First Address | Douglasville, GA 30135-1828 |
Second Address | Douglasville, GA 30135-1828 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 16/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00301122A | (05) | GA |
D42179 | (02) |