Provider Demographics
NPI:1659311645
Name:PATEL, NALINI A (MD)
Entity Type:Individual
Prefix:
First Name:NALINI
Middle Name:A
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 WATSON BLVD SUITE 2 #341
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3612
Mailing Address - Country:US
Mailing Address - Phone:478-396-8783
Mailing Address - Fax:478-922-5221
Practice Address - Street 1:1118 MORNINGSIDE DR
Practice Address - Street 2:STE B
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-4204
Practice Address - Country:US
Practice Address - Phone:478-396-8783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055489207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA593793560BMedicaid
GA11SCDWH GRP 7064Medicare ID - Type Unspecified
I21692Medicare UPIN