Provider Demographics
NPI:1225598816
Name:PATEL, SAGAR PRAVIN (MD)
Entity Type:Individual
Prefix:
First Name:SAGAR
Middle Name:PRAVIN
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 1:101 W MULBERRY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31407-3507
Mailing Address - Country:US
Mailing Address - Phone:912-350-6000
Mailing Address - Fax:912-350-6001
Practice Address - Street 1:101 W MULBERRY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31407-3507
Practice Address - Country:US
Practice Address - Phone:912-350-6000
Practice Address - Fax:912-350-6001
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA90096207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program