Provider Demographics
NPI:1437283645
Name:BHARAT PATEL M D P C
Entity Type:Organization
Organization Name:BHARAT PATEL M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARATKUMAR
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-432-9292
Mailing Address - Street 1:4015 S COBB DR SE STE 110
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6316
Mailing Address - Country:US
Mailing Address - Phone:770-432-9292
Mailing Address - Fax:770-432-1110
Practice Address - Street 1:4015 S COBB DR SE STE 110
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6316
Practice Address - Country:US
Practice Address - Phone:770-432-9292
Practice Address - Fax:770-432-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0486932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00878545AMedicaid
GA260045929OtherRAILROAD PROVIDER NUMBER
GA26BDHFJMedicare ID - Type UnspecifiedPROVIDER NUMBER
GA00878545AMedicaid