Provider Demographics
NPI:1114096328
Name:PATEL, CHIRAG G (DC)
Entity Type:Individual
Prefix:DR
First Name:CHIRAG
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5775 JIMMY CARTER BLVD
Mailing Address - Street 2:SUITE M 220 A
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-2989
Mailing Address - Country:US
Mailing Address - Phone:770-582-0873
Mailing Address - Fax:770-582-0863
Practice Address - Street 1:5775 JIMMY CARTER BLVD
Practice Address - Street 2:SUITE M 220 A
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-2989
Practice Address - Country:US
Practice Address - Phone:770-582-0873
Practice Address - Fax:770-582-0863
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007583111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAV08587Medicare UPIN
GA35ZCJNKMedicare ID - Type Unspecified