Basic Information
| Provider Information | |||||||||
| NPI: | 1770876096 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | NIMISHA | ||||||||
| MiddleName: | KANU | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3155 N POINT PKWY STE F100 | ||||||||
| Address2: | |||||||||
| City: | ALPHARETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300055495 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 JOHNSON FERRY RD | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048518000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2011 | ||||||||
| LastUpdateDate: | 07/22/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 52798 | TN | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 036.129154 | IL | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | MD.31919 | AL | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 79122 | GA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.