Organization
ATLANTA MINIMALLY INVASIVE SURGICAL ASSOC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIJAYKUMAR G PATEL MD (OWNER/PRESIDENT)
(770) 378-2449
Entity
Organization
Contact information
Practice address
1136 CLEVELAND AVE, SUITE 611, EAST POINT, GA 30344-3618
(770) 378-2449
(770) 252-8425
Mailing address
PO BOX 3335, PEACHTREE CITY, GA 30269-7335
(770) 378-2449
(770) 252-8425
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
043259
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000748294
—
GA
Enumeration date
12/16/2013
Last updated
12/16/2013
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