Provider Demographics
NPI:1255726865
Name:PATEL, NIRAJ (DO)
Entity type:Individual
Prefix:DR
First Name:NIRAJ
Middle Name:
Last Name:PATEL
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 PEACHTREE RD NW # 915-1643
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2870 PEACHTREE RD NW # 915-1643
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2918
Practice Address - Country:US
Practice Address - Phone:347-709-4042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS0969207Q00000X, 207QS0010X
CODR.0063414207Q00000X
CT65798207Q00000X
DCDO034954207Q00000X
FLOS16529207Q00000X
CA18511207Q00000X
AL2169207Q00000X
ARE-13264207Q00000X
AK149901207Q00000X
AZ008542207Q00000X
IL036.151580207Q00000X
HIDOS2024207Q00000X
IDOC-0067207Q00000X
GA85586207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine