Provider Demographics
NPI:1154548071
Name:PATEL, CHIRAG HASMUKH (MD)
Entity type:Individual
Prefix:DR
First Name:CHIRAG
Middle Name:HASMUKH
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 1:41 PARK OF COMMERCE WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-1369
Mailing Address - Country:US
Mailing Address - Phone:912-201-1540
Mailing Address - Fax:912-349-2609
Practice Address - Street 1:41 PARK OF COMMERCE WAY STE 200
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-1369
Practice Address - Country:US
Practice Address - Phone:912-201-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000322207L00000X
GA058715207LP2900X
FLME97782207LP2900X
GA58715208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003160917AMedicaid
FL280063200Medicaid
GA202I090908Medicare Oscar/Certification
GA202I090908Medicare PIN