Provider Demographics
NPI:1114258472
Name:PATEL, JIGAR A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JIGAR
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 ROCKY RUN PKWY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-1458
Mailing Address - Country:US
Mailing Address - Phone:302-477-3274
Mailing Address - Fax:302-477-1532
Practice Address - Street 1:1300 ROCKY RUN PKWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-1458
Practice Address - Country:US
Practice Address - Phone:302-477-3274
Practice Address - Fax:302-477-1532
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA1-0003678OtherPHARMACIST LICENSE