MEDICARE: NIRAV P 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	207RC0000X	Cardiovascular Disease Physician	104787	GA

General Provider Information

NPI Number	:	1710541636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIRAV P PATEL MD

Provider Business Mailing Address
First Line	:	1200 NORTHSIDE FORSYTH DR
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30041-7659
Country	:	US
Telephone Number	:	708-443-2007
Fax Number	:	833-337-8221

Provider Business Practice Location Address
First Line	:	1200 NORTHSIDE FORSYTH DR
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30041-7659
Country	:	US
Telephone Number	:	708-443-2007
Fax Number	:	833-337-8221

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

Provider Enumeration Date	:	04/25/2019
Last Update Date	:	03/06/2026

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