Provider Demographics
NPI:1346236510
Name:PATEL, SALIL J (MD)
Entity Type:Individual
Prefix:
First Name:SALIL
Middle Name:J
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:755 WALTHER RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-8725
Mailing Address - Country:US
Mailing Address - Phone:770-962-0399
Mailing Address - Fax:770-822-5389
Practice Address - Street 1:755 WALTHER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-8725
Practice Address - Country:US
Practice Address - Phone:770-962-0399
Practice Address - Fax:770-822-5389
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2021-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA44305207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0009555512CMedicaid
H76730Medicare UPIN
GA11BDWPNMedicare ID - Type Unspecified