Organization
SOUTHERN MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHIRAG R. PATEL MD (PRESIDENT)
(404) 761-1550
Entity
Organization
Contact information
Practice address
5329 N HENRY BLVD, STOCKBRIDGE, GA 30281-3224
(404) 761-1550
(404) 761-1558
Mailing address
5329 N HENRY BLVD, STOCKBRIDGE, GA 30281-3224
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
45908
GA
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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