Provider Demographics
NPI:1851484026
Name:PATEL, NATU M (MD)
Entity Type:Individual
Prefix:
First Name:NATU
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NATVARLAL
Other - Middle Name:M
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 650
Mailing Address - Street 2:
Mailing Address - City:SYLVESTER
Mailing Address - State:GA
Mailing Address - Zip Code:31791-0650
Mailing Address - Country:US
Mailing Address - Phone:229-776-7706
Mailing Address - Fax:229-776-2147
Practice Address - Street 1:813 S ISABELA STREET
Practice Address - Street 2:SUITE A
Practice Address - City:SYLVESTER
Practice Address - State:GA
Practice Address - Zip Code:31791-0650
Practice Address - Country:US
Practice Address - Phone:229-776-7706
Practice Address - Fax:229-776-2147
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA024320207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00252469AMedicaid
D40823Medicare UPIN