Healthcare Provider Details

I. General information

NPI: 1023270923
Provider Name (Legal Business Name): BHAVI PATEL PUROHIT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 WESTVIEW DR SW
ATLANTA GA
30310-1458
US

IV. Provider business mailing address

720 WESTVIEW DR SW
ATLANTA GA
30310-1458
US

V. Phone/Fax

Practice location:
  • Phone: 404-756-1230
  • Fax: 404-752-8682
Mailing address:
  • Phone: 404-752-1500
  • Fax: 404-752-8682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number002950
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: