Provider Demographics
NPI:1619976222
Name:PATEL, BHAVESH KUMAR GHANSHYAMBHAI (MD)
Entity Type:Individual
Prefix:DR
First Name:BHAVESH KUMAR
Middle Name:GHANSHYAMBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BHAVESH
Other - Middle Name:GHANSHYAMBHAI
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1326 EISENHOWER DR
Mailing Address - Street 2:BLDG 2
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3928
Mailing Address - Country:US
Mailing Address - Phone:912-527-5100
Mailing Address - Fax:912-527-5149
Practice Address - Street 1:1326 EISENHOWER DR
Practice Address - Street 2:BLDG 2
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3928
Practice Address - Country:US
Practice Address - Phone:912-527-5100
Practice Address - Fax:912-527-5149
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053356207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00089156OtherRR MEDICARE
GA470790179AMedicaid
GA866002OtherBCBS
SCG53356Medicaid
GAP00089156OtherRR MEDICARE
H91961Medicare UPIN