Provider Demographics
NPI:1073117354
Name:PATEL, NEEL KISHOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:NEEL
Middle Name:KISHOR
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ROCK CREST CIR SE
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30121-5293
Mailing Address - Country:US
Mailing Address - Phone:678-315-5467
Mailing Address - Fax:
Practice Address - Street 1:1905 MARTHA BERRY BLVD NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1649
Practice Address - Country:US
Practice Address - Phone:706-295-5717
Practice Address - Fax:706-295-5718
Is Sole Proprietor?:No
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist