Provider Demographics
NPI:1295725463
Name:PATEL, ANSHUL MAHENDRA (MD)
Entity type:Individual
Prefix:
First Name:ANSHUL
Middle Name:MAHENDRA
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 1:2300 MANCHESTER EXPY STE 2001A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-6802
Mailing Address - Country:US
Mailing Address - Phone:706-320-3126
Mailing Address - Fax:706-320-3054
Practice Address - Street 1:5671 PEACHTREE DUNWOODY RD
Practice Address - Street 2:SUITE 300 B
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1786
Practice Address - Country:US
Practice Address - Phone:404-778-6070
Practice Address - Fax:678-843-6350
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA60548207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA366826914AMedicaid
H69666Medicare UPIN
GA366826914AMedicaid