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General NPI Number Information
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NPI Number | 1497157648
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Entity Type | Individual
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Provider Name | SUJA PATEL PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 42 SURREY PLZ STE 48 SUITE 48
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City | HAWKINSVILLE
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State | GA
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Zip | 31036-4633
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Country | US
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Telephone | 478-783-3286
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Fax |
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Provider Business Mailing Address
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Address Line | 42 SURREY PLZ STE 48
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City | HAWKINSVILLE
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State | GA
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Zip | 31036-4633
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH-028037
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License Number State | GA
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