Provider Demographics
NPI:1093793192
Name:SONI-PATEL, PAYAL (PA-C)
Entity Type:Individual
Prefix:
First Name:PAYAL
Middle Name:
Last Name:SONI-PATEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 DOGWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2253
Mailing Address - Country:US
Mailing Address - Phone:828-210-9310
Mailing Address - Fax:828-210-9319
Practice Address - Street 1:31 DOGWOOD ROAD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2253
Practice Address - Country:US
Practice Address - Phone:828-210-9310
Practice Address - Fax:828-210-9319
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103448363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2755904BMedicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NO.
P62134Medicare UPIN