Provider Demographics
NPI:1366554917
Name:PATEL, RAJESH K (MD)
Entity type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3235 SATELLITE BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8688
Mailing Address - Country:US
Mailing Address - Phone:678-257-2547
Mailing Address - Fax:770-948-6804
Practice Address - Street 1:3235 SATELLITE BLVD STE 104
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8688
Practice Address - Country:US
Practice Address - Phone:678-595-9631
Practice Address - Fax:866-317-9099
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2020-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA047130208VP0000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF65733Medicare UPIN
GA05BDKRZMedicare ID - Type Unspecified