Individual
SONU MODY PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2400 MOUNT ZION PKWY, JONESBORO, GA 30236-2500
(404) 365-0966
Mailing address
317 CENTRAL AVE, JERSEY CITY, NJ 07307-2915
(201) 839-2640
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB10728200
NJ
207QA0505X
Adult Medicine Physician
90872
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114458544
NPI
NJ
Enumeration date
03/27/2017
Last updated
03/07/2023
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