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General NPI Number Information
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NPI Number | 1124190079
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Entity Type | Individual
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Provider Name | PREETESH P. PATEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 05/03/2021
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Provider Practice Location Address
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Address Line | 1295 HEMBREE ROAD STE 101
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City | ROSWELL
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State | GA
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Zip | 30076-3809
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Country | US
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Telephone | 770-948-6824
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Fax | 770-948-6804
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Provider Business Mailing Address
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Address Line | P.O. BOX 629
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City | AUSTELL
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State | GA
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Zip | 30168-1006
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Country | US
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Telephone | 770-948-6824
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Fax | 770-948-6804
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A94696
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 054631
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 054631
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 54631
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License Number State | GA
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