Provider Demographics
NPI:1982054151
Name:PATEL, HARSHIL
Entity Type:Individual
Prefix:
First Name:HARSHIL
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 STILESBORO RD NW STE 205
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-7765
Mailing Address - Country:US
Mailing Address - Phone:678-310-0540
Mailing Address - Fax:678-310-0538
Practice Address - Street 1:5205 STILESBORO RD NW STE 205
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7765
Practice Address - Country:US
Practice Address - Phone:678-310-0540
Practice Address - Fax:678-310-0538
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPR459213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery