Individual
KETAN M. PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 NORTHSIDE FORSYTH DR, CUMMING, GA 30041-7659
(770) 844-3200
(404) 851-6325
Mailing address
1200 NORTHSIDE FORSYTH DR, CUMMING, GA 30041-7659
(770) 844-3200
(404) 851-6325
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
63790
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000870001
DME PROVIDER
VA
01
—
110219768
RAILROAD MEDICARE
—
01
—
146213
SOUTHERN HEALTH
—
01
—
1804781000
WV MEDICAID
WV
01
—
20649
OPTIMA
VA
01
—
286053
ANTHEM/BCBS
—
05
—
473139726B
—
GA
05
—
5853745
—
VA
01
—
700027131
CIGNA
—
Enumeration date
07/31/2006
Last updated
01/19/2017
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