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NPI 1417244971

NPI 1417244971 : JULIE PATEL MD : MARIETTA, GA

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General NPI Number Information
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    NPI Number           |    1417244971
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    Entity Type          |    Individual 
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    Provider Name        |    JULIE PATEL MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/06/2011
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    Last Update Date     |    12/16/2020
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Provider Practice Location Address
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    Address Line         |    1010 JOHNSON FERRY RD 
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    City                 |    MARIETTA
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    State                |    GA
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    Zip                  |    30068-2108
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    Country              |    US
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    Telephone            |    770-579-7980
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    Fax                  |    770-439-3555
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Provider Business Mailing Address
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    Address Line         |    1010 JOHNSON FERRY RD 
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    City                 |    MARIETTA
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    State                |    GA
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    Zip                  |    30068-2108
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    Country              |    US
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    Telephone            |    770-579-7980
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    072767
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    License Number State |    GA
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