Provider Demographics
NPI:1023401239
Name:PATEL, AVANI (CNIM)
Entity Type:Individual
Prefix:
First Name:AVANI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 PARK WEST BLVD.
Mailing Address - Street 2:MADISON AT PARK WEST APT 107
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466
Mailing Address - Country:US
Mailing Address - Phone:734-395-5882
Mailing Address - Fax:734-994-8457
Practice Address - Street 1:1300 PARK WEST BLVD.
Practice Address - Street 2:MADISON AT PARK WEST APT 107
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466
Practice Address - Country:US
Practice Address - Phone:734-395-5882
Practice Address - Fax:734-994-8457
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other