Provider Demographics
NPI:1801341318
Name:PATEL, MACI M (NP)
Entity type:Individual
Prefix:MRS
First Name:MACI
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MACI
Other - Middle Name:M
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2081 NEWNAN CROSSING BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265
Mailing Address - Country:US
Mailing Address - Phone:423-608-7511
Mailing Address - Fax:
Practice Address - Street 1:2081 NEWNAN CROSSING BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2606
Practice Address - Country:US
Practice Address - Phone:470-592-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000021258363L00000X
GARN271349363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily