Provider Demographics
NPI:1083612642
Name:PATEL, NATU V (MD)
Entity Type:Individual
Prefix:MR
First Name:NATU
Middle Name:V
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 COX RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-3441
Mailing Address - Country:US
Mailing Address - Phone:704-854-9222
Mailing Address - Fax:704-854-9333
Practice Address - Street 1:635 COX RD
Practice Address - Street 2:SUITE E
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3441
Practice Address - Country:US
Practice Address - Phone:704-854-9222
Practice Address - Fax:704-854-9333
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27501207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-65958Medicaid
NC89-65958Medicaid
NC202971Medicare ID - Type Unspecified