Provider Demographics
NPI:1861523474
Name:PATEL, NARESH R (PHARMD, MBA)
Entity type:Individual
Prefix:DR
First Name:NARESH
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 BRAEMAR CT
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8741
Mailing Address - Country:US
Mailing Address - Phone:678-565-4255
Mailing Address - Fax:
Practice Address - Street 1:209 BRAEMAR CT
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8741
Practice Address - Country:US
Practice Address - Phone:678-565-4255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist