Provider Demographics
NPI:1235363813
Name:PATEL, SAGAR A (MD)
Entity Type:Individual
Prefix:
First Name:SAGAR
Middle Name:A
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 1:100 JIM MASON CT
Mailing Address - Street 2:STE A
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8965
Mailing Address - Country:US
Mailing Address - Phone:478-971-4001
Mailing Address - Fax:478-971-4004
Practice Address - Street 1:100 JIM MASON CT
Practice Address - Street 2:STE A
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8965
Practice Address - Country:US
Practice Address - Phone:478-971-4001
Practice Address - Fax:478-971-4004
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092442207L00000X
GA069609207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology