Patel, Champak

Patel, Champak is an individual health care provider with primary practice located at 5196 Hwy 53 , Braselton GA 30517. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Other Service Providers / Legal Medicine. Other Service Providers / Legal Medicine is his primary health care specialty. Patel, Champak can be contacted via phone (706) 824-9929.

Contact Information

Primary practice address
5196 Hwy 53 Braselton GA 30517
Phone: (706) 824-9929
Fax: (706) 654-9373
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 123503 New York
Other Service Providers / Legal Medicine 173000000X 059888 Georgia

Profile Details

NPI number 1073585782
LBN Legal business name Patel, Champak
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Jun 12th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073585782 NPPES
New York Other 000411428001 BLUE SHIELD
New York MEDICAID 00525411 BLUE SHIELD
New York Other 75786IM BLUE SHIELD
New York Other 11136 BLUE SHIELD
New York Other 141618275 BLUE SHIELD
New York Other 349351 BLUE SHIELD
New York MEDICAID 554972145A BLUE SHIELD

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