Individual
PRAKASH BHANUGHAC PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1571 HIGHWAY 21 S, SPRINGFIELD, GA 31329-5214
(912) 754-7500
Mailing address
1571 HIGHWAY 21 S, SPRINGFIELD, GA 31329-5214
(912) 754-7500
(912) 754-7505
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
045909
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000799092F
—
GA
Enumeration date
09/26/2006
Last updated
01/02/2019
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