Provider Demographics
NPI:1356563027
Name:PATEL, RAMESHCHANDRA D (OD)
Entity type:Individual
Prefix:DR
First Name:RAMESHCHANDRA
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:RAMESH
Other - Middle Name:D
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:3880 ANCROFT CIR
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2655
Mailing Address - Country:US
Mailing Address - Phone:770-416-1156
Mailing Address - Fax:
Practice Address - Street 1:2635 PLEASANT HILL RD
Practice Address - Street 2:VISION CENTER
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1450
Practice Address - Country:US
Practice Address - Phone:770-476-3125
Practice Address - Fax:770-476-2164
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT001346152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist