Healthcare Provider Details

I. General information

NPI: 1760693519
Provider Name (Legal Business Name): RESHMA VINOD PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 01/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 COLLIER RD NW SUITE 775
ATLANTA GA
30309-1613
US

IV. Provider business mailing address

35 COLLIER RD NW SUITE 775
ATLANTA GA
30309-1613
US

V. Phone/Fax

Practice location:
  • Phone: 404-367-3210
  • Fax: 404-367-3215
Mailing address:
  • Phone: 404-367-3210
  • Fax: 404-367-3215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number62414
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number062414
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: