Provider Demographics
NPI:1225008758
Name:PATEL, CHIRAG R (MD)
Entity Type:Individual
Prefix:
First Name:CHIRAG
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 CLEVELAND AVE STE 221
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-3618
Mailing Address - Country:US
Mailing Address - Phone:404-761-1550
Mailing Address - Fax:404-761-1558
Practice Address - Street 1:1136 CLEVELAND AVE STE 221
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344
Practice Address - Country:US
Practice Address - Phone:404-761-1550
Practice Address - Fax:678-233-1633
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA045908208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG69964Medicare UPIN
GA11BDVWRMedicare ID - Type Unspecified