MEDICARE: DR. NANDINI KAMLESH PATEL 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	207R00000X	Internal Medicine Physician	045578	GA

General Provider Information

NPI Number	:	1316047814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANDINI KAMLESH PATEL M.D

Provider Business Mailing Address
First Line	:	6948 GAINES RIDGE RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-3329
Country	:	US
Telephone Number	:	706-327-6236
Fax Number	:	706-544-3601

Provider Business Practice Location Address
First Line	:	6948 GAINES RIDGE RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-3329
Country	:	US
Telephone Number	:	706-327-6236
Fax Number	:	706-544-3601

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

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	07/08/2007

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