MEDICARE: DR. RAMESHCHANDRA D PATEL O.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	152W00000X	Optometrist	OPT001346	GA

General Provider Information

NPI Number	:	1356563027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMESHCHANDRA D PATEL O.D.

Provider Business Mailing Address
First Line	:	3880 ANCROFT CIR
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30092-2655
Country	:	US
Telephone Number	:	770-416-1156
Fax Number	:

Provider Business Practice Location Address
First Line	:	2635 PLEASANT HILL RD
Second Line	:	VISION CENTER
City	:	DULUTH
State	:	GA
Zip	:	30096-1450
Country	:	US
Telephone Number	:	770-476-3125
Fax Number	:	770-476-2164

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	12/16/2010

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