MEDICARE: SAMIT ATUL PATRAWALA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	075344	GA

General Provider Information

NPI Number	:	1083979397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMIT ATUL PATRAWALA M.D.

Provider Business Mailing Address
First Line	:	1100 LAKE HEARN DR
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30342-1523
Country	:	US
Telephone Number	:	404-365-0966
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 LAKE HEARN DR
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30342-1523
Country	:	US
Telephone Number	:	404-365-0966
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2012
Last Update Date	:	01/10/2022

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