Provider Demographics
NPI:1457606816
Name:PATEL, YOGIN (MD)
Entity Type:Individual
Prefix:
First Name:YOGIN
Middle Name:
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 1:1501 MILSTEAD RD NE STE 180
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3850
Mailing Address - Country:US
Mailing Address - Phone:678-374-7050
Mailing Address - Fax:678-374-7051
Practice Address - Street 1:1501 MILSTEAD RD NE STE 180
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3850
Practice Address - Country:US
Practice Address - Phone:678-374-7050
Practice Address - Fax:678-374-7051
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT201514207R00000X
KY49353207W00000X
OH35128577207W00000X
GA80132207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000001009824OtherANTHEM/BCBS
OH0167633Medicaid
IN201358280Medicaid