Healthcare Provider Details

I. General information

NPI: 1902897788
Provider Name (Legal Business Name): KAMLESH NATVARLAL PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424A WARM SPRINGS RD
COLUMBUS GA
31904-5638
US

IV. Provider business mailing address

2424A WARM SPRINGS RD
COLUMBUS GA
31904-5638
US

V. Phone/Fax

Practice location:
  • Phone: 706-327-6296
  • Fax: 706-571-0036
Mailing address:
  • Phone: 706-327-6296
  • Fax: 706-571-0036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number045576
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number21755
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: