| NPI | 1972243780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVI R PATEL Owner 706-676-4836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2022-03-30 |