Provider Demographics
NPI:1124780622
Name:PATEL, ALYSSA M (PA-C)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:PATEL
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3225 CUMBERLAND BLVD SE STE 520
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6407
Mailing Address - Country:US
Mailing Address - Phone:678-915-2000
Mailing Address - Fax:404-868-3363
Practice Address - Street 1:3225 CUMBERLAND BLVD SE STE 520
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-6407
Practice Address - Country:US
Practice Address - Phone:678-915-2000
Practice Address - Fax:404-868-3363
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA10567363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical