Individual
MITAL PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
575 PROFESSIONAL DR, LAWRENCEVILLE, GA 30046-3333
(678) 312-5200
Mailing address
575 PROFESSIONAL DR STE 150, LAWRENCEVILLE, GA 30046-3347
(678) 312-5200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
86221
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
86221
GA
208VP0014X
Interventional Pain Medicine Physician
86221
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2015
Last updated
03/26/2021
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