Provider Demographics
NPI:1003221995
Name:PATEL, NEETY (MD)
Entity Type:Individual
Prefix:
First Name:NEETY
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 LARGENT WAY NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064
Mailing Address - Country:US
Mailing Address - Phone:678-581-5830
Mailing Address - Fax:678-581-5835
Practice Address - Street 1:3707 LARGENT WAY NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-5140
Practice Address - Country:US
Practice Address - Phone:678-581-5830
Practice Address - Fax:678-581-5835
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA272829207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine