MEDICARE: MAULIKKUMAR 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	207R00000X	Internal Medicine Physician	008812	GA
2	207RC0000X	Cardiovascular Disease Physician	83626	GA

General Provider Information

NPI Number	:	1831551126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAULIKKUMAR PATEL MD

Provider Business Mailing Address
First Line	:	9202 HIGHWAY 278 NE STE 100E
Second Line	:
City	:	COVINGTON
State	:	GA
Zip	:	30014-7011
Country	:	US
Telephone Number	:	678-342-8677
Fax Number	:	404-609-5301

Provider Business Practice Location Address
First Line	:	9202 HIGHWAY 278 NE STE 100E
Second Line	:
City	:	COVINGTON
State	:	GA
Zip	:	30014-7011
Country	:	US
Telephone Number	:	678-342-8671
Fax Number	:	404-609-5301

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

Provider Enumeration Date	:	03/24/2016
Last Update Date	:	05/02/2024

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