Physician Compare National (NPI:1407849524)

HEALTHCARE PROVIDER: DIPAK B PATEL M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1407849524
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8729151089
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080718000506
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PATEL
	Individual professional last name
Provider First Name	DIPAK
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4745 NELSON BROGDON BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 200
	Group Practice or individual's line 2 address
City	BUFORD
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	305185404
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110005
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTHSIDE HOSPITAL FORSYTH
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110087
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GWINNETT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	110029
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	NORTHEAST GEORGIA MEDICAL CENTER, INC
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	110161
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	NORTHSIDE HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	110230
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	EMORY JOHNS CREEK HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	M

Physician Compare National (NPI:1407849524)

HEALTHCARE PROVIDER: DIPAK B PATEL M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information