Basic Information
| Provider Information | |||||||||
| NPI: | 1235758566 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | TULSI | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 230 E DERENNE AVE | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314056736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9127904068 | ||||||||
| FaxNumber: | 9127904407 | ||||||||
| Practice Location | |||||||||
| Address1: | 109 MINUS AVENUE | ||||||||
| Address2: | SUITE 10 | ||||||||
| City: | GARDEN CITY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9129665445 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2020 | ||||||||
| LastUpdateDate: | 09/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.