Individual
DR. TARAK VIPINCHANDRA PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1224 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-6582
(706) 922-0191
(706) 922-0192
Mailing address
1224 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-6582
(706) 922-0191
(706) 922-0192
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2008-01629
NC
207RI0200X
Infectious Disease Physician
Primary
066394
GA
208M00000X
Hospitalist Physician
43503
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116928A
—
GA
01
—
52533620
BCBS OF GA
GA
05
—
GA1232
—
SC
Enumeration date
10/11/2007
Last updated
08/29/2024
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