Healthcare Provider Details

I. General information

NPI: 1811810542
Provider Name (Legal Business Name): NISHA PATEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 CHURCH ST NE
MARIETTA GA
30060-1101
US

IV. Provider business mailing address

200 HUTCHINSON ST NE UNIT A
ATLANTA GA
30307-2827
US

V. Phone/Fax

Practice location:
  • Phone: 470-267-6844
  • Fax:
Mailing address:
  • Phone: 470-267-6844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberRPH032112
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: