Individual
JAY DIPAK PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2615
(770) 897-7043
(770) 996-3941
Mailing address
11 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2615
(770) 897-7043
(770) 996-3941
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
88748
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003255080A
—
GA
Enumeration date
03/20/2018
Last updated
09/30/2021
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