Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 062073 | GA |
NPI | 1083812523 |
---|---|
Provider Name | Viralkumar Sureshchandra Patel |
First Address | Lithia Springs, GA 30122-2899 |
Second Address | Smyrna, GA 30080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2007 |
Last Update Date | 15/12/2009 |