Provider Demographics
NPI:1699705525
Name:PATEL, TRUSHARTH ARVIND (MD)
Entity type:Individual
Prefix:DR
First Name:TRUSHARTH
Middle Name:ARVIND
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TRU
Other - Middle Name:ARVIND
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:MOT 7TH FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2208
Mailing Address - Country:US
Mailing Address - Phone:404-686-2410
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:MOT, 7TH FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2208
Practice Address - Country:US
Practice Address - Phone:404-686-2410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006015409207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I059627OtherMEDICARE PTAN