Provider Demographics
NPI:1316047814
Name:PATEL, NANDINI KAMLESH (MD)
Entity type:Individual
Prefix:DR
First Name:NANDINI
Middle Name:KAMLESH
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6948 GAINES RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-3329
Mailing Address - Country:US
Mailing Address - Phone:706-327-6236
Mailing Address - Fax:706-544-3601
Practice Address - Street 1:6948 GAINES RIDGE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-3329
Practice Address - Country:US
Practice Address - Phone:706-327-6236
Practice Address - Fax:706-544-3601
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA045578207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAVAD000Medicare UPIN