Provider Demographics
NPI:1184911760
Name:PATEL, ANUJ ASHWIN (PHARMD)
Entity type:Individual
Prefix:MR
First Name:ANUJ
Middle Name:ASHWIN
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4241 MILLSIDE WALK SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6334
Mailing Address - Country:US
Mailing Address - Phone:678-485-5203
Mailing Address - Fax:
Practice Address - Street 1:20 GLENLAKE PKWY NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3473
Practice Address - Country:US
Practice Address - Phone:770-677-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist