Provider Demographics
NPI:1225912769
Name:PATEL, KHUSHBUBEN H
Entity type:Individual
Prefix:
First Name:KHUSHBUBEN
Middle Name:H
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 ABINGDON CV
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:31005-3880
Mailing Address - Country:US
Mailing Address - Phone:770-374-3159
Mailing Address - Fax:
Practice Address - Street 1:921 ABINGDON CV
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005-3880
Practice Address - Country:US
Practice Address - Phone:770-374-3159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant