Healthcare Provider Details

I. General information

NPI: 1962935585
Provider Name (Legal Business Name): RONAK PATEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 JOE FRANK HARRIS PKWY SE
CARTERSVILLE GA
30120-2129
US

IV. Provider business mailing address

1514 SHERIDAN RD NE APT 3002
ATLANTA GA
30324-5458
US

V. Phone/Fax

Practice location:
  • Phone: 470-490-2142
  • Fax:
Mailing address:
  • Phone: 706-231-6287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number101069
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number83393
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number101069
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: