Provider Demographics
NPI:1164543344
Name:LAVANIA, HIRAL (MD)
Entity Type:Individual
Prefix:DR
First Name:HIRAL
Middle Name:
Last Name:LAVANIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HIRAL
Other - Middle Name:ASHOKKUMAR
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2575 PEACHTREE PKWY STE 301
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7559
Mailing Address - Country:US
Mailing Address - Phone:678-962-7337
Mailing Address - Fax:
Practice Address - Street 1:3155 N POINT PKWY
Practice Address - Street 2:BUILDING D, SUITE 200
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-5481
Practice Address - Country:US
Practice Address - Phone:770-667-6967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001750208000000X
GA062412208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA458498552AMedicaid