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Organization

PINECCA PATEL DPM LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAUREN KAESER (CHIEF OPERATING OFFICER)
(912) 844-4329
Entity
Organization

Contact information

Practice address
6 EXECUTIVE PARK DR NE STE 10, ATLANTA, GA 30329-2224
(404) 321-9900
(404) 321-4460
Mailing address
6 EXECUTIVE PARK DR NE STE 10, ATLANTA, GA 30329-2224
(404) 321-9900
(404) 321-4460

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001059
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003202355
GA
Enumeration date
05/24/2018
Last updated
05/24/2018
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