MEDICARE: SAGAR PRAVIN PATEL MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	90096	GA

General Provider Information

NPI Number	:	1225598816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAGAR PRAVIN PATEL MD

Provider Business Mailing Address
First Line	:	101 W MULBERRY BLVD STE 100
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31407-3507
Country	:	US
Telephone Number	:	912-350-6000
Fax Number	:	912-350-6001

Provider Business Practice Location Address
First Line	:	101 W MULBERRY BLVD STE 100
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31407-3507
Country	:	US
Telephone Number	:	912-350-6000
Fax Number	:	912-350-6001

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

Provider Enumeration Date	:	03/21/2019
Last Update Date	:	09/12/2022

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