Individual
VIRAL MAINAK PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1255 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4526
(404) 367-3014
Mailing address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6406
(816) 271-7986
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
005441
GA
207R00000X
Internal Medicine Physician
Primary
73779
GA
208M00000X
Hospitalist Physician
2015022429
MO
208M00000X
Hospitalist Physician
73779
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508126780
—
MO
05
—
201124300A
—
KS
01
—
P01584894
RR MEDICARE
MO
Enumeration date
05/22/2012
Last updated
08/26/2022
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