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General NPI Number Information
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NPI Number | 1093547259
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Entity Type | Individual
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Provider Name | SOHIL MUKESH PATEL PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/16/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 1829 LAWRENCEVILLE HWY
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City | DECATUR
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State | GA
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Zip | 30033-5728
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Country | US
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Telephone | 404-292-8335
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Fax |
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Provider Business Mailing Address
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Address Line | 5405 VILLAGE VIEW LN
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-3166
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Country | US
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Telephone | 706-836-0117
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 12672
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License Number State | GA
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