Provider Demographics
NPI:1770920258
Name:PATEL, BHAVIKA RAJANIKANT (MD)
Entity type:Individual
Prefix:
First Name:BHAVIKA
Middle Name:RAJANIKANT
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3895 CHEROKEE ST. NW #400
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144
Mailing Address - Country:US
Mailing Address - Phone:678-369-7755
Mailing Address - Fax:844-947-4544
Practice Address - Street 1:3895 CHEROKEE ST. NW #400
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144
Practice Address - Country:US
Practice Address - Phone:678-369-7755
Practice Address - Fax:844-947-4544
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-40376207Q00000X
GA76120207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine