Provider Demographics
NPI:1174837231
Name:PATEL, NEEL ANILKUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:NEEL
Middle Name:ANILKUMAR
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2637 KINNETT CT SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-5739
Mailing Address - Country:US
Mailing Address - Phone:770-608-3728
Mailing Address - Fax:
Practice Address - Street 1:3840 PEACHTREE INDUSTRIAL BLVD STE 2275
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096
Practice Address - Country:US
Practice Address - Phone:770-608-3728
Practice Address - Fax:404-600-1178
Is Sole Proprietor?:No
Enumeration Date:2010-07-31
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA663912085R0202X, 2085R0204X
PAMD4398012085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003119505EMedicaid