Provider Demographics
NPI:1659571628
Name:PATEL, RAVI MANGAL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:MANGAL
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 UPPER GATE DR NE
Mailing Address - Street 2:DEPT OF NEONATOLOGY, 3RD FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1014
Mailing Address - Country:US
Mailing Address - Phone:404-727-3360
Mailing Address - Fax:404-727-3236
Practice Address - Street 1:2015 UPPER GATE DR NE
Practice Address - Street 2:DIVISION OF NEONATOLOGY, 3RD FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1014
Practice Address - Country:US
Practice Address - Phone:404-727-3360
Practice Address - Fax:404-727-3236
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060690208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics