Provider Demographics
NPI:1639576069
Name:DVIR ASSOCIATES, INC
Entity Type:Organization
Organization Name:DVIR ASSOCIATES, INC
Other - Org Name:MINIMALLY INVASIVE CENTER OF ATLANTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEEL
Authorized Official - Middle Name:ANILKUMAR
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-608-3728
Mailing Address - Street 1:2637 KINNETT CT SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-5739
Mailing Address - Country:US
Mailing Address - Phone:770-608-3728
Mailing Address - Fax:404-600-1178
Practice Address - Street 1:3840 PEACHTREE INDUSTRIAL BLVD STE 275
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096
Practice Address - Country:US
Practice Address - Phone:404-977-1238
Practice Address - Fax:404-600-1178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0663912085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003119505EMedicaid