Provider Demographics
NPI:1831416270
Name:PATEL, NIDHIP ANIL (DO)
Entity type:Individual
Prefix:
First Name:NIDHIP
Middle Name:ANIL
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 116360
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-6360
Mailing Address - Country:US
Mailing Address - Phone:678-312-5600
Mailing Address - Fax:678-312-0439
Practice Address - Street 1:500 MEDICAL CENTER BLVD STE 310
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3332
Practice Address - Country:US
Practice Address - Phone:678-312-0500
Practice Address - Fax:678-312-0525
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12132207R00000X, 208000000X
GA73620207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics