Provider Demographics
NPI:1245529783
Name:PATEL, CHINTAK BALVANTRAI (MD)
Entity type:Individual
Prefix:DR
First Name:CHINTAK
Middle Name:BALVANTRAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4600 WATERS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6702
Mailing Address - Country:US
Mailing Address - Phone:912-355-2462
Mailing Address - Fax:912-353-1836
Practice Address - Street 1:4600 WATERS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6702
Practice Address - Country:US
Practice Address - Phone:912-355-2462
Practice Address - Fax:912-353-1836
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA72392208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA72392OtherMD LICENSE