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NPI Code Detail

MEDICARE: DR. RAJENDRA F PATEL M.D.

MEDICARE: DR. RAJENDRA F 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
1207Q00000XFamily Medicine Physician021781GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1581571997OTHERGAFEDERAL EMPLOYER I D

General Provider Information

NPI Number : 1316940836
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAJENDRA F PATEL M.D.
Provider Business Mailing Address
First Line : 2965D JOHNSON FERRY RD
Second Line :
City : MARIETTA
State : GA
Zip : 30062-5653
Country : US
Telephone Number : 770-998-5000
Fax Number : 770-552-2869
Provider Business Practice Location Address
First Line : 2965D JOHNSON FERRY RD
Second Line :
City : MARIETTA
State : GA
Zip : 30062-5653
Country : US
Telephone Number : 770-998-5000
Fax Number : 770-552-2869
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2005
Last Update Date : 06/22/2011

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