Provider Demographics
NPI:1366859233
Name:PATEL, CHINMAY M (MD)
Entity Type:Individual
Prefix:
First Name:CHINMAY
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3604 BELLHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-1210
Mailing Address - Country:US
Mailing Address - Phone:229-444-2299
Mailing Address - Fax:
Practice Address - Street 1:247 NORTHSIDE DR STE B
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602
Practice Address - Country:US
Practice Address - Phone:229-253-1206
Practice Address - Fax:229-253-1209
Is Sole Proprietor?:No
Enumeration Date:2014-07-12
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GABM6733807-Q426207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine