Provider Demographics
NPI:1780028779
Name:PATEL, SUNIL RAMESHBHAI
Entity Type:Individual
Prefix:
First Name:SUNIL
Middle Name:RAMESHBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 VINEYARD WAY
Mailing Address - Street 2:APT # 610
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-9146
Mailing Address - Country:US
Mailing Address - Phone:914-339-0231
Mailing Address - Fax:
Practice Address - Street 1:2020 VINEYARD WAY
Practice Address - Street 2:APT # 610
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-9146
Practice Address - Country:US
Practice Address - Phone:914-339-0231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115764207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine