Healthcare Provider Details

I. General information

NPI: 1982054151
Provider Name (Legal Business Name): HARSHIL PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3459 ACWORTH DUE WEST RD NW STE 430
ACWORTH GA
30101-5823
US

IV. Provider business mailing address

3459 ACWORTH DUE WEST RD NW STE 430
ACWORTH GA
30101-5823
US

V. Phone/Fax

Practice location:
  • Phone: 678-310-0540
  • Fax: 678-310-0538
Mailing address:
  • Phone: 678-310-0540
  • Fax: 678-310-0538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPR459
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: