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Organization
SHIVDHARAA LLC
Active
Organization
SHIVDHARAA LLC
Active
Other names
EVOLVE MEDICAL CARE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
BIJAL PATEL NP (OWNER)
(678) 643-5580
Entity
Organization
Contact information
Practice address
3639 LAWRENCEVILLE HWY # 7, LAWRENCEVILLE, GA 30044-4107
(404) 940-2033
Mailing address
2515 HAYNES CLUB CIR, GRAYSON, GA 30017-2814
(678) 643-5580
(888) 542-9103
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/12/2022
Last updated
05/08/2024
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