MEDICARE: ALPA B. PATEL DPM

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	213E00000X	Podiatrist	36003019P	OH
2	213E00000X	Podiatrist	POD001000	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851378186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALPA B. PATEL DPM

Provider Business Mailing Address
First Line	:	921 CHECKERED WAY NW
Second Line	:
City	:	KENNESAW
State	:	GA
Zip	:	30152
Country	:	US
Telephone Number	:	770-596-2376
Fax Number	:	706-232-6750

Provider Business Practice Location Address
First Line	:	101 JOHN MADDOX DR NW STE A
Second Line	:
City	:	ROME
State	:	GA
Zip	:	30165-1419
Country	:	US
Telephone Number	:	706-232-6739
Fax Number	:	706-232-6750

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	09/09/2017

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Directions to “ ALPA B. PATEL DPM” Practice Location

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