Individual
DEEP GAUTAM PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC/L
Contact information
Practice address
11685 ALPHARETTA HWY, ROSWELL, GA 30076-4913
(770) 619-3842
Mailing address
5575 FORDS CROSSING CT NW, ACWORTH, GA 30101-4806
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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