Provider Demographics
NPI:1497331474
Name:PATEL PLASTIC SURGERY LLC
Entity Type:Organization
Organization Name:PATEL PLASTIC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIRAV
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:470-395-6932
Mailing Address - Street 1:11459 JOHNS CREEK PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-3517
Mailing Address - Country:US
Mailing Address - Phone:470-395-6932
Mailing Address - Fax:
Practice Address - Street 1:11459 JOHNS CREEK PKWY STE 240
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-3517
Practice Address - Country:US
Practice Address - Phone:470-395-6932
Practice Address - Fax:470-395-6951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service