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General NPI Number Information
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NPI Number | 1962612630
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Entity Type | Individual
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Provider Name | PRASHANT V PATIL MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 450 NORTHSIDE CHEROKEE BLVD
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City | CANTON
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State | GA
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Zip | 30115-8015
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Country | US
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Telephone | 770-224-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 450 NORTHSIDE CHEROKEE BLVD
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City | CANTON
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State | GA
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Zip | 30115-8015
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Country | US
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Telephone | 707-224-1000
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 69126
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME106548
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L2663
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MT190229
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License Number State | PA
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