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Individual

DR. NISHA PANICKER ARAVINDAKSHAN PATEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD, MPH

Contact information

Practice address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 489-9005
(844) 443-3963
Mailing address
543 WINTON TER NE UNIT A, ATLANTA, GA 30308-2826
(706) 489-9005
(844) 443-3963

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
207172
LA
207R00000X
Internal Medicine Physician
67339-20
WI
207R00000X
Internal Medicine Physician
75597
GA
207R00000X
Internal Medicine Physician
ME132196
FL
207RI0200X
Infectious Disease Physician
207172
LA
207RI0200X
Infectious Disease Physician
67339-20
WI
207RI0200X
Infectious Disease Physician
Primary
75597
GA
207RI0200X
Infectious Disease Physician
ME132196
FL
208M00000X
Hospitalist Physician
Primary
75597
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003180254Q
GA
05
003180254S
GA
05
003261734A
GA
05
202I210707
GA
05
2361368
LA
05
GA2058
SC
05
XC527
FL
Enumeration date
04/23/2010
Last updated
04/24/2026
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