MEDICARE: DR. MANISH MAHENDRA PATEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	50241	GA

General Provider Information

NPI Number	:	1518981364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANISH MAHENDRA PATEL M.D.

Provider Business Mailing Address
First Line	:	1600 CLIFTON; MS A-47
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30333
Country	:	US
Telephone Number	:	404-639-2343
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 CLIFTON; MS A-47
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30333
Country	:	US
Telephone Number	:	404-639-2343
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	06/21/2011

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