Provider Demographics
NPI:1083211767
Name:PATEL, PATRICK DHANSUKHBHAI (PHARM D)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:DHANSUKHBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:PRATIKKUMAR
Other - Middle Name:D
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:635 PAUL HUFF PKWY NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-2970
Mailing Address - Country:US
Mailing Address - Phone:423-476-4393
Mailing Address - Fax:
Practice Address - Street 1:635 PAUL HUFF PKWY NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-2970
Practice Address - Country:US
Practice Address - Phone:423-476-4393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist