Provider Demographics
NPI:1033449277
Name:PATEL, NIKUNJ (MPHARM)
Entity Type:Individual
Prefix:MR
First Name:NIKUNJ
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3487 STOCKTON HILL RD
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3681
Mailing Address - Country:US
Mailing Address - Phone:928-692-1822
Mailing Address - Fax:928-692-6404
Practice Address - Street 1:3487 STOCKTON HILL RD
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3681
Practice Address - Country:US
Practice Address - Phone:928-692-1822
Practice Address - Fax:928-692-6404
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS016415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist