Provider Demographics
NPI:1588058564
Name:PATEL, PRATIK (MD)
Entity type:Individual
Prefix:DR
First Name:PRATIK
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 N DRUID HILLS RD NE OFC CL14321
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3117
Mailing Address - Country:US
Mailing Address - Phone:434-444-4244
Mailing Address - Fax:
Practice Address - Street 1:2220 N DRUID HILLS RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-3117
Practice Address - Country:US
Practice Address - Phone:434-444-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA806852080P0207X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology