Provider Demographics
NPI:1225045057
Name:PATEL, BIPINCHANDRA RAOJIBHAI (MD, FACS, FACRS)
Entity Type:Individual
Prefix:
First Name:BIPINCHANDRA
Middle Name:RAOJIBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD, FACS, FACRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11459 JOHNS CREEK PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-3517
Mailing Address - Country:US
Mailing Address - Phone:470-395-6932
Mailing Address - Fax:470-395-6951
Practice Address - Street 1:11459 JOHNS CREEK PKWY STE 240
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-3517
Practice Address - Country:US
Practice Address - Phone:470-395-6932
Practice Address - Fax:470-395-6951
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY137389208C00000X
NY137389208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00738409Medicaid
NYNY LICENSE#137389OtherNEWYORK STATE LICENSE
NYNY LICENSE#137389OtherNEWYORK STATE LICENSE
NY00738409Medicaid
NY39121BMedicare ID - Type Unspecified