Provider Demographics
NPI:1699924241
Name:NAMITA PATEL, LLC
Entity type:Organization
Organization Name:NAMITA PATEL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:NAMITA
Authorized Official - Middle Name:G
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:404-822-6105
Mailing Address - Street 1:109 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3905
Mailing Address - Country:US
Mailing Address - Phone:404-822-6105
Mailing Address - Fax:678-669-1750
Practice Address - Street 1:109 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3905
Practice Address - Country:US
Practice Address - Phone:404-822-6105
Practice Address - Fax:678-669-1750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty