Healthcare Provider Details

I. General information

NPI: 1164543344
Provider Name (Legal Business Name): HIRAL LAVANIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HIRAL ASHOKKUMAR PATEL M.D.

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 PEACHTREE PKWY STE 301
CUMMING GA
30041-7563
US

IV. Provider business mailing address

2575 PEACHTREE PKWY STE 301
CUMMING GA
30041-7559
US

V. Phone/Fax

Practice location:
  • Phone: 678-962-7337
  • Fax:
Mailing address:
  • Phone: 678-962-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number001750
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number062412
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: